Lavignac C, Jauberteau-Marchan M O, Liozon E, Vidal E, Catanzano G, Liozon F
Département d' anatomie pathologique, CHU, Limoges, France.
Rev Med Interne. 1996;17(10):814-20. doi: 10.1016/0248-8663(96)82684-1.
The immunohistochemical study was performed on temporal artery biopsies from eight patients with giant cell (temporal) arteritis: three before treatment, four after a short period of corticosteroid therapy (from 1 day to 7 days) and one during relapse occurring after a treatment of 9 years; from four subjects with clinical symptoms but without histological features of giant cell arteritis and from five negative controls. Before treatment, biopsies of patients with temporal arteritis showed an inflammatory infiltrate with macrophages and T cells, essentially CD4+ and memory T cells (CD45 RO+), expressing the markers of activation IL2 receptor and HLA DR. Few B and NK cells were also detected. Adhesion molecules, LFA1 and I-CAM1, were strongly expressed by T cells and macrophages. In contrast, the ligand to the CD2, the CD58 marker, was rarely detected. These immunohistochemical features were also observed after a short corticosteroid treatment (by intravenous methylprednisolone or oral prednisone), with presence of activated T cells, memory T cells, macrophages and I-CAM1 and LFA1 expressing cells in the infiltrate. A temporal biopsy, performed after a long time of corticosteroid therapy, showed activated T cells, macrophages and memory cells in o,ne arteriole. In controls, this study showed some mononuclear cells dispersed in intima and adventia, but without activated or memory T cells. Our results support the presence of immune local response in temporal arteritis, incompletely improved by a short corticosteroid treatment.
对8例巨细胞(颞)动脉炎患者的颞动脉活检组织进行了免疫组织化学研究:3例在治疗前,4例在短期糖皮质激素治疗(1天至7天)后,1例在9年治疗后复发期间;4例有临床症状但无巨细胞动脉炎组织学特征的受试者以及5例阴性对照。治疗前,颞动脉炎患者的活检显示有巨噬细胞和T细胞的炎性浸润,主要为CD4 +和记忆T细胞(CD45 RO +),表达活化标志物IL2受体和HLA DR。也检测到少量B细胞和NK细胞。T细胞和巨噬细胞强烈表达黏附分子LFA1和I-CAM1。相比之下,CD2的配体CD58标志物很少被检测到。短期糖皮质激素治疗(静脉注射甲泼尼龙或口服泼尼松)后也观察到这些免疫组织化学特征,浸润中有活化的T细胞、记忆T细胞、巨噬细胞以及表达I-CAM1和LFA1的细胞。长期糖皮质激素治疗后的颞动脉活检显示一条小动脉中有活化的T细胞、巨噬细胞和记忆细胞。在对照中,该研究显示一些单核细胞分散在内膜和外膜中,但无活化或记忆T细胞。我们的结果支持颞动脉炎中存在免疫局部反应,短期糖皮质激素治疗不能完全改善这种反应。