Fokkens W J, Nolst Trenite G J, Virmond M, KleinJan A, Andrade V L, van Baar N G, Naafs B
Department of Otorhinolaryngology, Erasmus University Medical Center, Rotterdam, The Netherlands.
Int J Lepr Other Mycobact Dis. 1998 Sep;66(3):328-39.
A detailed study of the nose was undertaken in 40 leprosy patients with different classifications of leprosy and different durations of disease at two hospitals in Brazil. This manuscript describes the immunohistochemical data on cellular infiltrates in the nasal biopsies of those patients. It was surprising that the damage to the whole depth of the nasal mucosa, epithelium and lamina propria was considerable, as was the case in the nasal mucosa which looked relatively normal during clinical inspection. The epithelium showed large holes which looked like very extended goblet cells. Very obvious was the lack of vasoconstriction after cocaine application, and the vessels also showed a lack of staining with factor VIII, possibly indicating a disruption of the endothelium. The number of neurofilaments was extensively reduced in all leprosy groups compared to normal controls. As in the skin, an increased number of CD68+ cells was found in the lamina propria of the nasal mucosa of the lepromatous patients. Contrary to findings in the skin, in the nasal mucosa of the borderline/lepromatous patients the number of CD4+ cells was increased and the number of CD8+ cells was decreased compared to normal controls. The number of CD8+ cells tended to be more reduced when the history of leprosy was longer. It is not clear as yet whether the reduced numbers of CD8+ cells are acquired during infection or whether persons with a low number of CD8+ cells in the nose might have a higher risk of acquiring leprosy.
在巴西的两家医院，对40名患有不同麻风病分类和不同病程的麻风病患者的鼻子进行了详细研究。本手稿描述了这些患者鼻活检中细胞浸润的免疫组织化学数据。令人惊讶的是，鼻黏膜、上皮和固有层的全层损伤相当严重，而在临床检查中看起来相对正常的鼻黏膜也是如此。上皮显示出大的孔洞，看起来像非常扩张的杯状细胞。可卡因应用后血管收缩缺乏非常明显，并且血管对因子VIII染色也缺乏，这可能表明内皮细胞受到破坏。与正常对照组相比，所有麻风病组中的神经丝数量均大幅减少。与皮肤情况一样，在瘤型麻风患者的鼻黏膜固有层中发现CD68+细胞数量增加。与皮肤中的发现相反，与正常对照组相比，界线类/瘤型麻风患者的鼻黏膜中CD4+细胞数量增加，CD8+细胞数量减少。麻风病史越长，CD8+细胞数量减少的趋势越明显。目前尚不清楚CD8+细胞数量减少是在感染期间获得的，还是鼻子中CD8+细胞数量少的人感染麻风病的风险可能更高。
