口腔扁平苔藓中朗格尔汉斯细胞的研究

Langerhans cells in the oral licen planus

目的:观察口腔扁平苔藓(OLP)颊粘膜损害及正常对照颊粘膜上皮中的朗格尔汉斯细胞(LC)数量及分布,角质细胞HLA-DR抗原的表达及分布,探讨OLP的病理形成机制。方法:采用SABC免疫组化方法,利用S-100多克隆抗体及HLA-DR单克隆抗体对25例OLP颊粘膜损害标本及8例正常对照颊粘膜标本进行检测。结果:LC对S-100抗体及HLA-DR抗体染色阳性,在对照组中LC主要位于基底细胞层,偶见于基底细胞层上方,固有层中少见。在OLP组中,LC位于棘细胞层的中、下部及基底细胞层,有的标本中LC可见于棘细胞全层,固有层中多见。OLP组LC计数明显高于对照组(P<0.001)。OLP组有56%的标本(14/25)显示存在HLA-DR+角质细胞。在OLP损害中,固有层中淋巴细胞浸润程度与基底细胞变性程度相关,固有层中淋巴细胞浸润程度越重,基底细胞变性程度越重。结论:LC将处理过的抗原复合体提呈给抗原特异性的细胞毒性T淋巴细胞,从而使角质细胞成为细胞介导的免疫损伤的靶细胞,这种免疫介导的对基底细胞的损伤对在OLP的发生中起重要作用。

Objective：To observe the number and distribution of langerhans cells（LCs） and the expression of HLA-DR antigen in oral licen planus（OLP） and normal control buccal mucosa, and therefore to explore the pathogenesis of OLP. Methods： Polyclonal antibody to S-100 protein and monoclonal antibody to HLA-DR antigens were applied to paraffin-embedded sections by SABC immunohistochemical method in 25 cases of OLP and 8 cases of normal control. Resuits： LCs were identified with anit-S-100 and anti-HLA-DR. In normal buccal mucosa, LCs mainly located in the basal cell layer, occasionally in the upper basal layer; whereas in OLP, they mainly located in the middle and lower regions of the prickle cell layer and the basal cell layer, but throughout the prickle cell layer in some. S-100 ＋ LC and HLA-DR^＋ LC significantly increased in the epithelia of OLP （P 〈0.001）, and 56% of the OLP specimens（14/25 ） showed HLADR ＋ keratinocytes. There was correlation between the severity of the lymphatic infiltration in lamina propria and the basal cell degeneration in OLP, and more severe the lymophatic infiltration was, more severe the basal cell degeneration was. Conclusions： Presenting specified antigen to cytotoxic T cell, LCs induce the degeneration of keratinocytes. The cellular immunity mediated by cytotoxic T cells may play a major role in the pathogenesis of OLP, and therefore LC may play an important role for OLP.