口腔扁平苔藓和苔藓样损害中的B细胞浸润与临床疗效相关性分析  

Correlation analysis of B-cell infiltration and clinical efficacy in oral lichen planus and oral lichenoid lesion

作　　者：冯铭华 赖漪娆 邓一文[1] 黎希晔 潘蕾[1] 田臻[2] 王宇峰[1] 唐国瑶[1,3] FENG Ming-hua;LAI Yi-rao;DENG Yi-wen;LI Xi-ye;PAN Lei;TIAN Zhen;WANG Yu-feng;TANG Guo-yao(Department of Oral Medicine,Shanghai Ninth People's Hospital,Shanghai JiaoTong University School of Medicine·Department of Oral Mucosa/College of Stomatology,Shanghai JiaoTong University/National Center for Stomatology/National Clinical Research Center for Oral Diseases/Shanghai Key Laboratory of Stomatology,Shanghai Research Institute of Stomatology,Shanghai 200011,China;Department of Oral Medicine,Shanghai Ninth People's Hospital,Shanghai JiaoTong University School of Medicine·Department of Oral Pathology/College of Stomatology,Shanghai JiaoTong University/National Center for Stomatology/National Clinical Research Center for Oral Diseases/Shanghai Key Laboratory of Stomatology,Shanghai Research Institute of Stomatology,Shanghai 20001l,China;Department of Stomatology,Shanghai Xin Hua Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China)

机构地区：[1]上海交通大学医学院附属第九人民医院·口腔黏膜病科,上海交通大学口腔医学院,国家口腔医学中心,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海市口腔医学研究所,上海200011 [2]上海交通大学医学院附属第九人民医院·口腔病理科,上海交通大学口腔医学院,国家口腔医学中心,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海市口腔医学研究所,上海200011 [3]上海交通大学医学院附属新华医院,上海200092

出　　处：《临床口腔医学杂志》2023年第10期596-601,共6页Journal of Clinical Stomatology

基　　金：国家自然科学基金项目(编号82205200、82020108010、82270976);上海交通大学医学院高水平地方高校协同创新团队(SHSMU-ZLCX20212401);上海市卫生健康委员会临床研究专项基金(202040458)。

摘　　要：目的:分析口腔扁平苔藓(oral lichen planus,OLP)和苔藓样损害(oral lichenoid lesion,OLL)中的B细胞数量比例、分布状态和浸润特点,并评价其与临床治疗转归的相关性。方法:收集OLP、OLL和健康口腔黏膜组织,应用单细胞测序技术分析组织中的B细胞表型和数量比例;另回顾性收集OLP组织31例、OLL组织69例,应用免疫组化染色观察CD20^(+)B细胞和CD20^(+)IL-10^(+)B细胞在组织中的浸润部位、数量比例和浸润特点,进一步评价这些特点与临床治疗效果的相关性。结果:单细胞测序结果显示,B细胞在OLP、OLL和健康黏膜中占总细胞数量分别为4.34%、0.59%、0.44%,其中IL-10^(+)的调节性B细胞约占总B细胞数量分别为1%、0.94%、1.35%;GO分析显示,OLP、OLL中B细胞的功能主要富集在胞质翻译产物等方面。免疫组化结果显示,OLP组和OLL组中存在CD20^(+)B细胞浸润。OLP组和OLL组中分别有92.9%、41.9%病例数的CD20^(+)B细胞分布于固有层浅层(P<0.0001),25.0%、62.9%病例数存在B细胞灶性分布(P=0.0009)。而在OLP和OLL损害中均罕见共表达CD20和IL-10的细胞类型。OLP和OLL两组中存在B细胞浸润(B^(+))的病例,其治疗前后的REU评分差异均具有统计学意义(P值均<0.01),而无明显B细胞浸润(B-)的病例,治疗前后REU评分差异无统计学意义(P值均>0.05);OLP队列中B^(+)组和B-组的治疗前后REU差值相比,差异无统计学意义(P=0.659),而OLL队列两个亚组的治疗前后REU差值差异存在统计学意义(P<0.05)。结论:CD20^(+)B细胞广泛存在于OLP和OLL损害中,B细胞的浸润数量与口服糖皮质激素的治疗效果有关,但其确切的临床意义和病理机制仍有待进一步研究。Objective:To analyze the number,distribution,and invasion characteristics of B cells on oral lichen planus(OLP)and oral lichenoid lesion(OLL),and to evaluate the correlation between B cells and clinical outcome.Methods:OLP,OLL and healthy oral mucosa tissues were collected.Single cell sequencing technology was used to analyze the phenotype and number ratio of B cells in tissues.In addition,31 cases of OLP tissue and 69 cases of OLL tissue were retrospectively collected,and immunohistochemical staining was used to observe the site,proportion and infiltration characteristics of CD20^(+)B cells and CD20^(+)IL-10^(+)B cells in the tissues,so as to further evaluate the correlation between these characteristics and clinical therapeutic effect.Results:The results of single cell sequencing showed that the number of B cells in OLP,OLL and healthy mucosa was 4.34%,0.59% and 0.44%,respectively,and the number of IL-10^(+)regulatory B cells was 1%,0.94% and 1.35%,respectively.GO analysis showed that the function of B cells in OLP and OLL was mainly enriched in cytoplasmic translation production.Immunohistochemical results showed that CD20^(+)B cells infiltrated in OLP and OLL groups.And 92.9% of CD20^(+)B cells in OLP group,41.9%in OLL group were distributed in the lamina propria(P<0.0001),25.0% and 62.9% of cases had focal distribution of B cells(P=0.0009).However,in both OLP and OLL lesions,few cell types co-express CD20 and IL-10.B cell infiltration(B^(+))in OLP and OLL groups showed statistically significant differences in REU scores before and after treatment(P<0.01),and there was no significant difference in the REU score before and after treatment in the cases without obvious B cell infiltration(B^(-))(P<0.05).There was no statistically significant difference in the difference of REU before and after treatment between the B^(+)and B^(-)groups in the OLP cohort(P=0.659),but there was statistically significant difference in the difference of REU between the two subgroups in the OLL cohort(P<0.05).Conclusion:CD20^(+)B cel

关 键 词：口腔扁平苔藓 口腔苔藓样损害 B淋巴细胞 调节性B细胞 单细胞测序 

分 类 号：R781.5[医药卫生—口腔医学]