系统性红斑狼疮患者CD1a、CD68、HLA-DR等的研究  

CD1a.CD68 and HLA-DR Antigens in the Skin of Patients with Systemic Lupus Erythematosus

作　　者：赵玉铭[1] 王雅坤[1] 赖鑫[1] 王岩[1] 陈洪铎[1] 

机构地区：[1]中国医科大学第一临床学院皮肤科,沈阳110001

出　　处：《中华皮肤科杂志》2002年第1期25-27,共3页Chinese Journal of Dermatology

基　　金：国家自然科学基金资助课题(39970681)

摘　　要：目的研究系统性红斑狼疮(SLE)患者外观正常及病变皮肤中朗格汉斯细胞(LC)一些重要表面标志的变化。方法应用CD1a、CD68和HLA-DR等单克隆抗体和ABC免疫组化技术对9例SLE患者外观正常和皮损部位的组织进行了免疫表型检测。结果①SLE皮损中LC的数量减少,且其形态与表面标志亦有变化;②SLE病损处的角质形成细胞(KC)强弱不等地表达HLA-DR抗原,个别病例的外观正常皮肤KC也可局灶性表达HLA-DR抗原;③SLE外观正常皮肤或皮损的表皮中均未见细胞间粘附分子1和CD4阳性LC,仅在真皮的浸润细胞中见到较多的阳性细胞;④发现在SLE外观正常皮肤和皮损表皮内出现两类CD68阳性的树枝状细胞;在SLE皮损的浸润细胞中CD68阳性树枝状细胞大量增加;⑤细纤维状CD68阳性物质呈网状围绕基底部的KC,这些细纤维状阳性物质有些与表皮树枝状细胞相连,有些则没有明显的关系。结论SLE外观正常和病变皮肤中LC一些重要表面标志的变化有所不同。外观正常皮肤和皮损表皮内出现两类树枝状细胞,一类可能为LC,而另一类则来源不清;在SLE皮损的浸润细胞中这些CD68阳性树枝状细胞大量增加,表皮内存在CD68阳性纤维状染色,其意义尚需进一步研究。Objective To study the changes in some important surface markers of Langerhans cell (LC) in the skin of SLE patients. Methods The normal-appearing skin and lesional skin of 9 SLE patients were studied. ABC immunohistochemistry and the monoclonal antibodies against HLA-DR, CD54, CD68, CD1a and CD4 were used. Results ①In SLE skin lesions decreased LC density was shown,and there were also changes in the morphology and surface markers of LC. ②HLA-DR expression on keratinocytes was shown in most lesional specimens and a few on non-lesional specimens. ③Neither CD4 nor CD54 expression was shown on both lesional epidermis and non-lesional epidermis, CD4+cells were only observed in the dermal infiltrates. ④Two types of CD68+dendritic cells were seen in lesional and non-lesional epidermis, and more CD68+dendritic cells were seen in the infiltrates of lesional skin. ⑤Fibrillar CD68+materials around the basal KC were observed, and some of such fibrillar materials were connected with epidermal dendritic cells while others were not. Conclusions There are some differences in LC surface marker expression on lesional skin and non-lesional skin of SLE patients, which need to be further studied.

关 键 词：系统性红斑狼疮 朗格尔汉斯细胞 免疫表型分型 CD1A CD68 HLA-DR 

分 类 号：R593.241[医药卫生—内科学]