巨噬细胞在局限性硬皮病和系统性硬化症皮损中的极化状态  

Macrophage Polarization in Localized Scleroderma and Systemic Scleroderma Lesions

作　　者：王芳[1] 李心欣 李曼 丁晓岚[1] 徐前喜[1] 杜娟[1] WANG Fang;LI Xinxin;LI Man;DING Xiaolan;XU Qianxi;DU Juan(Department of Dermatology,Beijing 100044,China;Department of Dermatology,Beijing Friendship Hospital,Capital Medical University,Peking University People's Hospital,Beijing 100050,China)

机构地区：[1]北京大学人民医院皮肤科,北京100044 [2]首都医科大学附属北京友谊医院皮肤科,北京100050

出　　处：《中国皮肤性病学杂志》2023年第10期1127-1132,共6页The Chinese Journal of Dermatovenereology

基　　金：北京市自然科学基金项目(7214262)。

摘　　要：目的研究局限性硬皮病(localized scleroderma,LS)和系统性硬化症(systemic sclerosis,SSc)患者皮损中M1、M2型巨噬细胞的表达分布和与真皮胶原容积的相关性。方法收集本科确诊的24例LS患者、18例SSc患者和10例健康人对照的皮肤组织,采用免疫组织化学标记总巨噬细胞(CD68+)及其亚型M1型(iNOS+)和M2型(CD163+)在真皮中的表达分布,用Masson法染色并测定胶原容积分数(CVF),与患者病程等比较。结果LS组和SSc组皮损的真皮层可见较多CD68+巨噬细胞,LS组(32.54±12.12)/HP、SSc组(21.83±7.28)/HP和对照组(6.70±2.83)/HP,LS组和SSc组分别与对照组比较差异均有统计学意义(P<0.05);其中,三组皮损中iNOS+M1型巨噬细胞均低表达,差异无统计学意义(P>0.05);CD163+M2型巨噬细胞浸润在LS组和SSc组表达均高于对照组(P<0.05),差异均有统计学意义。根据病程分层,LS组早期(≤1年)皮损和晚期(>1年)皮损中CD163+M2型巨噬细胞浸润数量差异无统计学意义(P>0.05);SSc组病程分层得出一致趋势。LS组和SSc组胶原容积分数(CVF)水平均高于对照组(P<0.01);然而Pearson相关性分析显示,LS组和SSc组皮损中M2型巨噬细胞数量均与CVF无线性关联(r=-0.06、-0.12,P>0.05)。结论LS和SSc患者皮损中均存在巨噬细胞向M2型极化,提示其在病程早晚期均发挥作用,但可能与皮肤纤维化程度无直接线性关联。Objective To study the expression distribution of M1 and M2 macrophages in the skin of patients with localized scleroderma(LS)and systemic sclerosis(SSc)and their correlation with dermal collagen volume fraction(CVF).Methods Skin tissues were collected from 24 patients with LS and 18 patients with SSc in our clinic as well as from 10 healthy control patients.The expression and distribution of CD68 labeled total resident macrophages(CD68+),iNOS labeled M1 phenotype http://pfxbxzz.paperopen.com(iNOS+)and CD163 labeled M2 phenotype(CD163+)were detected by immunohistochemical staining and the CVF was determined by Masson staining.The expression of total and M1/M2 subtypes of macrophages was compared between disease groups and stages.Results An increased number of CD68+macrophages were observed in the skin dermis of both LS and SSc groups.The number of CD68+macrophages were(32.54±12.12)/HP in the LS group,(21.83±7.28)/HP in the SSc group,and(6.70±2.83)/HP in the control group,suggesting significant difference(P<0.05).iNOS+M1 macrophages in the three groups were poorly expressed in all three groups with no statistically significant difference(P>0.05),while CD163+M2 macrophage infiltration was statistically significantly higher in both the LS and SSc groups compared with the control group(P<0.05).According to the stratification of clinical stage,there was no difference in the number of CD163+M2 macrophage infiltrates in early(≤1 year)and late(>1 year)lesions in the LS group(P>0.05),which was consistent with the results in the SSc group.The CVF levels in the LS group and SSc group were both higher than those in the control group(P<0.01);however,Pearson correlation analysis showed that there was no linear correlation between the number of M2 macrophages in the lesions of LS and SSc groups and CVF(r=-0.06,-0.12,P>0.05).Conclusion Macrophage polarization towards M2 phenotype is present in the skin lesions of both LS and SSc patients,indicating that it plays a role in both the early and late stages of the disease,but ma

关 键 词：局限性硬皮病 系统性硬化症 巨噬细胞极化 M1/M2型 促纤维化 

分 类 号：R593.25[医药卫生—内科学]