早期梅毒皮损形成机制的研究

Study on the formation mechanism of early syphilitic lesions

目的探讨形成早期梅毒皮损的可能机制。方法分别用常规病理、银染及免疫组化法检测30例早期梅毒皮损组织中的病理变化、梅毒螺旋体和Th1/Th2细胞因子的表达。结果一期梅毒硬下疳和二期梅毒的结节、斑块、丘疹、脓疱等皮损中有典型的梅毒组织学结构和梅毒螺旋体,而斑疹损害中无典型的梅毒组织学结构和梅毒螺旋体。硬下疳中Th1型细胞因子表达占优势,二期梅毒患者的结节、斑块、丘疹、脓疱等皮损中Th1/Th2型细胞因子的表达视梅毒螺旋体感染时间长短而不同,Th2型细胞因子的表达主要见于感染时间较长的皮损,而斑疹中Th2型细胞因子表达与梅毒螺旋体的感染时间无关。结论二期梅毒斑疹损害可能因机体的变态反应引起。

Objective To explore the possible formation mechanism of early syphilitic lesions. Method The lesions of 30 early syphilitic cases were examined by means of routine pathology, silver staining and immunohistochemistry to observe the pathological changes in the lesions and to locate Treponema pallidura as well as the expression of Th1/Th2 cytokines. Results There were typical syphilitic pathological changes, and presence of T. pallidum in chancre and in different types of secondary syphilitic lesions except macula. Thl cytokines were predominant in chancre. In secondary syphilitic lesions the expression of Th1/Th2 cytokines varied according to the duration of the infection. Th2 cytokines were often seen in those lesions of long duration, except macular lesions. The expression of Th2 cytokines in macular lesions was not related to the duration of infection. Conclusion The macular lesions of secondary syphilis may be caused by hypersensitive reaction.