瘢痕疙瘩上皮细胞增殖和免疫诱导与毛囊-皮脂腺结构破坏

Relationship between the proliferation and immunoinduction of epithelial cells and the destruction of hair follicles and sebaceous glands in keloids

目的探讨瘢痕疙瘩(K)上皮细胞生物学行为对毛囊皮脂腺(HFSG)转归的影响。方法收集K边缘部位和正常皮肤(NS)标本,采用组织化学和免疫组化染色方法,观察结构正常和异常的HFSG上皮细胞表达免疫黏附分子和细胞角蛋白14(CK14)以及局部活性淋巴细胞浸润情况。结果与NS不同,KHFSG上皮细胞异常增殖,结构畸变、解体或形成复层鳞状上皮(皮岛样)结构,其密度随着结缔组织增生、成熟而逐渐降低;在强表达细胞间黏附分子(ICAM)1、D相关人类白细胞抗原位点(HLADR)和CK14的KHFSG周围,有相应的CD4、CD45RO和γ干扰素(IFNγ)阳性免疫细胞浸润,二者之间统计学呈明显的正相关。结论KHFSG结构破坏与反应性上皮细胞增生免疫诱导增强有关。

Objective To investigate the influence of biological behavior of epithelial cells on the hair follicles and sebaceous glands （HFSG） structure in keloids （K）. Methods The expression of intercellular adhesion molecule （ ICAM ）-1, D-related human leucocyte antigen （ HLA-DR ）, and cytokeratin （CK） 14 on epithelial cells and the amount of activity T-lymphocytes were detected in specimens of keloid edge and normal skin with immunohistochemical and histological methods. Results In comparison with normal skin specimens, epithelial cells were proliferated in K-HFSG presented structural aberration and disintegrate or abnormally to form solid-epithelial island-like structure, and the density of HSFG with hyperplasia and the ageing scar in keloids was apparently decreased . They strongly expressed ICAM-1, HLA-DR, and CK14 in the epithelial cells, there were many immunologic cells which expressed CD4, CD45RO, and interferen（IFN）-γ around the K-HFSG. The expressed level of epithelial cells was positively correlated with the density of immunologic cells nearby K-HFSG. Conclusion It could be concluded that the reactivity with hyperplasia and immunoinduction of epithelial cells might be associated with the destruction of the some HFSG structure in the keloids.