Seko Y, Takahashi N, Sato O, Takagi A, Yagita H, Okumura K, Yazaki Y
Third Department of Internal Medicine, University of Tokyo, Japan.
Int Angiol. 1998 Jun;17(2):89-92.
We report a rare case of an atherosclerotic aortic aneurysm with lymphocyte infiltration in which T-cell receptor (TCR) Valpha as well as Vbeta gene usage was restricted. Immunohistochemical studies showed that the infiltrating cells mainly consisted of macrophages, natural killer (NK) cells, cytotoxic T lymphocytes (CTLs) and T-helper (Th) cells, and that there were almost no infiltrating delta T lymphocytes, and human leukocyte antigen (HLA) class I and 65-kD heat-shock protein (HSP-65) was not strongly expressed in the aortic tissue. Although the immunohistochemical data were consistent with an ordinary atherosclerotic aortic aneurysm, in which TCR Valpha-Vbeta gene usage is known to be polyclonal, the restricted TCR gene usage suggests that a certain autoimmune mechanism was involved in the pathogenesis of this case similar to Takayasu's arteritis, in which massive infiltration of delta T lymphocytes and strong expression of HSP-65 in the aortic tissue are characteristic.
我们报告了一例罕见的伴有淋巴细胞浸润的动脉粥样硬化性主动脉瘤病例，其中T细胞受体（TCR）α链以及β链基因的使用受到限制。免疫组织化学研究显示，浸润细胞主要由巨噬细胞、自然杀伤（NK）细胞、细胞毒性T淋巴细胞（CTL）和辅助性T（Th）细胞组成，几乎没有浸润的δT淋巴细胞，并且人类白细胞抗原（HLA）I类和65-kD热休克蛋白（HSP-65）在主动脉组织中未强烈表达。尽管免疫组织化学数据与普通的动脉粥样硬化性主动脉瘤一致，在普通动脉粥样硬化性主动脉瘤中已知TCRα-β基因的使用是多克隆的，但TCR基因使用受限表明，与高安动脉炎类似，某种自身免疫机制参与了该病例的发病过程，高安动脉炎的特征在于主动脉组织中有大量δT淋巴细胞浸润以及HSP-65的强烈表达。
