副肿瘤性天疱疮抗Dsg1和抗Dsg3抗体滴度及亚型和细胞因子的表达  

The Study on Anti-Dsg1,Dsg3 Antibody Subclass Production and Cytokines Expression in the Patients with Paraneoplastic Pemphigus

作　　者：陈娅苑[1] 朱海琴[1] 潘萌[1] 郑捷[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院皮肤科,上海200025

出　　处：《中国皮肤性病学杂志》2011年第3期167-170,共4页The Chinese Journal of Dermatovenereology

基　　金：国家自然科学基金项目资助(30771932);上海市科委基础研究重点项目资助(10JC1410600)

摘　　要：目的对不同病期的副肿瘤性天疱疮(PNP)患者血清中抗桥粒芯糖蛋白(Dsg)1和抗Dsg3抗体的滴度、亚型及其外周血单个核细胞(PBMC)中细胞因子IFN-γ和IL-4水平进行观察,探讨PNP的特殊发病机制。方法采用ELISA法检测6例PNP患者不同病期抗Dsg1和抗Dsg3抗体滴度及其IgG1和IgG4抗体亚型;采用流式细胞术(FCM)检测上述患者PBMC中T细胞的IFN-γ和IL-4水平,并与10例寻常型天疱疮(PV)患者、10例落叶型天疱疮(PF)患者及20例正常对照进行比较。结果 PNP患者组在急性期抗Dsg1和抗Dsg3抗体滴度均升高,稳定期均明显降低,抗Dsg1和抗Dsg3抗体亚型IgG1/IgG4均以IgG1为主,与PV组相比,差异均有统计学意义(P均<0.05),与PF组患者的抗Dsg1抗体亚型IgG1/IgG4比较,差异也有统计学意义(P<0.01);PNP组患者CD8+T细胞及CD4+T细胞内IFN-γ水平明显高于PV组患者和PF组患者(P=0.001),且稳定期CD8+T细胞及CD4+T细胞内IFN-γ水平较急性期明显降低(P<0.05)。PNP组急性期患者的CD4+T细胞内IL-4水平显著低于PV组患者(P<0.05)和PF组患者(P<0.01),但在稳定期时,其水平与急性期比较,差异无统计学意义(P>0.05)。结论 PNP患者在抗Dsg1和Dsg3抗体的亚型、细胞因子等方面与其他类型的天疱疮存在明显差异。Objective To investigate antibody titers against Desmoglein 1 and 3 （Dsgl and 3） and the IgG subclasses in serum and levels of IFN-γ ,IL-4 in peripheral blood mononuelear cells （PBMC） in the patients with paraneoplastic pemphigus （PNP） in different stage. Methods Six patients with PNP, ten patients with pemphigus vugalris（PV） , ten patients with pemphigus foliaceus （PF） and tewenty healthy people were enrolled in the study. Antibodies against Dsgl and Dsg 3 and subclasses of the antibodies in serum were evaluated by ELISA. T cell cytokines, including IFN-γand IL-4 were measured by flow cytometry （FCM）. Results 1 Antibody titers against Dsg 1 and Dsg 3 in acute patients with PNP were remarkably increased compared with those in re-mission （P 〈 0.05） . 2 IgG1 subclass in acute patients with PNP was at higher level and the ratio of IgG1/ IgG4 in acute patients with PNP was reversed to that in the patients with PV （ratio of anti-Dsgl IgG1/IgG4 ： P = 0. 001 ; ratio of anti-Dsg3 IgG1/IgG4 ： P 〈 0.05 ） and PF （ ratio of anti-Dsgl IgG1/IgG4 ： P 〈 0.01 ）. 3 The IFN-γ expression from CD8 ^＋ T cells or CD4^＋ T cells was significantly higher in PNP patients compared with that in controls （P = 0.001 ） , and it was remakably decreased in remission patients compared with acute patients（ P 〈 0.05） . The IL-4 expression from CD4^ ＋T cell was significantly lower in PNP group compared with PV（P 〈 0.05 ）and PF（P 〈 0.01 ）but there is no significant difference in acute or remission patients（P 〉 0. 05）. Conclusion The subclasses of antibodies against Dsgl and Dsg3 and cytokines expression in PNP patients are quite different when compared with PV and PF patients.

关 键 词：副肿瘤性天疱疮 抗Dsg1抗体 抗Dsg3抗体 抗体亚型 细胞因子 

分 类 号：R758.66[医药卫生—皮肤病学与性病学]