Katayama I, Igawa K, Minatohara K, Nishioka K
Department of Dermatology, Tokyo Medical and Dental University School of Medicine, Japan.
Clin Exp Allergy. 1997 Dec;27(12):1477-83. doi: 10.1046/j.1365-2222.1997.1610974.x.
In a last decade, new types of skin manifestations have been recognized in atopic dermatitis especially in Japan. They are frequently observed in adult patients with atopic dermatitis after a long-standing steroid ointment and termed adult type-atopic dermatitis.
To clarify whether topical glucocorticoid (GC) modulates cutaneous inflammatory reactions in addition to known anti-inflammatory effect, we have examined the effect of long-term application of topical GC on IgE-mediated murine cutaneous reactions.
Fifty microlitres of diflucortolone valerate (1 mg/mL), prednisolone valerateacetate (3 mg/mL), or triamcinolone acetonide (1 mg/mL) were applied seven times on alternate day, to the flank skin of mice. On day 12 when mice received the seventh application of GC, each mouse was given an intravenous application of IgE anti-DNP antibody (PCA titre > x 2560) 1 h before the skin test with 0.15% DNFB in acetone:olive oil (4:1) on the right pinna. The left pinna was painted with a vehicle as a control. Increased ear thickness was measured at 1, 4, 24, 48 and 72 h to assess the augmentry effect of GC.
Topical application of GC (50 microg diflucortolone valerate in ethanol) on the flank skin seven times on alternate days, augmented expression of passive cutaneous anaphylaxis reaction on the ear skin induced by intravenous applications of monoclonal IgE anti-DNP antibody and following the challenge test. In contrast, topical application of GC inhibited the reactions when applied on the challenged sites. Several types of GC, but not vitamin D3, augmented the skin reactions and these augmented reactions persisted for 72 h when control skin reactions subsided. GC induced a late phase but not an early phase cutaneous reaction in mast cell deficient WBB6F1 v/v mice by IgE anti-DNP antibody.
Long-term application of topical GC might modulate local cutaneous immune response and augment IgE-mediated cutaneous reactions. Fc epsilon R(+) cells other than mast cell might be involved in the IgE-mediated late-phase reaction.
在过去十年中,尤其是在日本,特应性皮炎中已识别出新型皮肤表现。它们常见于长期使用类固醇软膏的成年特应性皮炎患者,被称为成人型特应性皮炎。
为了阐明局部糖皮质激素(GC)除了已知的抗炎作用外是否还能调节皮肤炎症反应,我们研究了长期局部应用GC对IgE介导的小鼠皮肤反应的影响。
将50微升戊酸地夫可特(1毫克/毫升)、醋酸泼尼松龙(3毫克/毫升)或曲安奈德(1毫克/毫升)隔日涂抹7次在小鼠侧腹皮肤。在第12天,当小鼠接受第7次GC涂抹时,在使用0.15%二硝基氟苯于丙酮:橄榄油(4:1)对右耳廓进行皮肤试验前1小时,给每只小鼠静脉注射IgE抗DNP抗体(PCA滴度>×2560)。左耳廓涂抹赋形剂作为对照。在1、4、24、48和72小时测量耳厚度增加情况,以评估GC的增强作用。
隔日7次在小鼠侧腹皮肤局部应用GC(50微克戊酸地夫可特溶于乙醇),增强了静脉注射单克隆IgE抗DNP抗体后及激发试验诱导的耳廓皮肤被动皮肤过敏反应的表达。相反,在激发部位应用GC时可抑制反应。几种类型的GC可增强皮肤反应,但维生素D3无此作用,且当对照皮肤反应消退时,这些增强的反应可持续72小时。GC通过IgE抗DNP抗体在肥大细胞缺陷的WBB6F1 v/v小鼠中诱导迟发性而非早发性皮肤反应。
长期局部应用GC可能调节局部皮肤免疫反应并增强IgE介导的皮肤反应。除肥大细胞外的FcεR(+)细胞可能参与IgE介导的迟发性反应。