Watson R E, Parry E J, Humphries J D, Jones C J, Polson D W, Kielty C M, Griffiths C E
Section of Dermatology, University of Manchester, Hope Hospital, Salford, U.K.
Br J Dermatol. 1998 Jun;138(6):931-7. doi: 10.1046/j.1365-2133.1998.02257.x.
Striae distensae (striae: stretch marks) are a common disfiguring condition associated with continuous and progressive stretching of the skin--as occurs during pregnancy. The pathogenesis of striae is unknown but probably relates to changes in those structures that provide skin with its tensile strength and elasticity. Such structures are components of the extracellular matrix, including fibrillin, elastin and collagens. Using a variety of histological techniques, we assessed the distribution of these extracellular matrix components in skin affected by striae. Pregnant women were assessed for the presence of striae, and punch biopsies were obtained from lesional striae and adjacent normal skin. Biopsies were processed for electron microscopy, light microscopy and immunohistochemistry. For histological examination, 7 microns frozen sections were stained so as to identify the elastic fibre network and glycosaminoglycans. Biopsies were also examined with a panel of polyclonal antibodies against collagens I and III, and fibrillin and elastin. Ultrastructural analysis revealed alterations in the appearance of skin affected by striae compared with that of normal skin in that the dermal matrix of striae was looser and more floccular. Light microscopy revealed an increase in glycosaminoglycan content in striae. Furthermore, the number of vertical fibrillin fibres subjacent to the dermal-epidermal junction (DEJ) and elastin fibres in the papillary dermis was significantly reduced in striae compared with normal skin. The orientation of elastin and fibrillin fibres in the deep dermis showed realignment in that the fibres ran parallel to the DEJ. However, no significant alterations were observed in any other extracellular matrix components. This study identifies a reorganization and diminution of the elastic fibre network of skin affected by striae. Continuous strain on the dermal extracellular matrix, as occurs during pregnancy, may remodel the elastic fibre network in susceptible individuals and manifest clinically as striae distensae.
膨胀纹（striae：妊娠纹）是一种常见的毁容性病症，与皮肤的持续渐进性拉伸有关——比如在怀孕期间发生的情况。膨胀纹的发病机制尚不清楚，但可能与那些赋予皮肤抗张强度和弹性的结构变化有关。这些结构是细胞外基质的组成部分，包括原纤蛋白、弹性蛋白和胶原蛋白。我们使用多种组织学技术，评估了这些细胞外基质成分在受膨胀纹影响的皮肤中的分布。对孕妇进行膨胀纹检查，并从病变膨胀纹和相邻正常皮肤处获取打孔活检组织。活检组织进行电子显微镜、光学显微镜和免疫组织化学处理。为进行组织学检查，对7微米厚的冰冻切片进行染色，以识别弹性纤维网络和糖胺聚糖。活检组织还使用一组针对I型和III型胶原蛋白、原纤蛋白和弹性蛋白的多克隆抗体进行检查。超微结构分析显示，与正常皮肤相比，受膨胀纹影响的皮肤外观有改变，即膨胀纹的真皮基质更疏松、更呈絮状。光学显微镜检查显示膨胀纹中糖胺聚糖含量增加。此外，与正常皮肤相比，膨胀纹中真皮-表皮交界处（DEJ）下方的垂直原纤蛋白纤维数量和乳头真皮中的弹性蛋白纤维数量显著减少。深层真皮中弹性蛋白和原纤蛋白纤维的方向显示重新排列，即纤维与DEJ平行排列。然而，在任何其他细胞外基质成分中均未观察到明显改变。本研究确定了受膨胀纹影响的皮肤弹性纤维网络的重组和减少。真皮细胞外基质上的持续应变，如在怀孕期间发生的情况，可能会使易感个体的弹性纤维网络重塑，并在临床上表现为膨胀纹。
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