免疫球蛋白在增生性瘢痕及瘢痕疙瘩中的表达

Immunoglobulin expression on hypertrophic scars and keloids in immunohistochemical study

对３５例增生性瘢痕、８例瘢痕疙瘩及７例正常皮肤用免疫组化（ＡＢＣ）法进行免疫球蛋白ＩｇＧ、ＩｇＡ、ＩｇＭ、ＩｇＥ及Ｃ４的分析。本文试图从免疫学方面探讨瘢痕形成有关的免疫性因素。增生性瘢痕及瘢痕疙瘩中ＩｇＧ、ＩｇＡ、ＩｇＭ免疫球蛋白及补体Ｃ４的分布均沿胶原纤维方向沉积，在真皮乳头层血管周围及真皮胶原纤维间，特别在瘢痕结节处，结节内胶原周边较多，在细胞内也有。ＩｇＥ主要沉积在肥大细胞内，染色均较深，量较多。而正常皮肤中ＩｇＡ、ＩｇＧ、ＩｇＥ及Ｃ４也有不同程度沉积，但染色浅淡，数量少。结果表明，在增生性瘢痕、瘢痕疙瘩中免疫球蛋白沉积均比正常皮肤含量多，染色深，增生性瘢痕与瘢痕疙瘩中无明显差异。这些免疫球蛋白可能是ＤＮＡ－抗ＤＮＡ抗体复合物，这些复合物可来自血循环或是损伤后真皮抗核抗体与表皮抗原结合而产生，说明瘢痕的形成和发展与免疫性有关。证实瘢痕发病机理中有局限性免疫反应存在，亦即机体免疫系统在瘢痕发生。

In order to investigate the role of immunoglobulin in the pathogenesis of hypertrophic scars and keloid, 35 cases of hypertrophic scar, 8 cases of keloid and 7 cases of normal skin were detected by immunohistochemical (Avidin-biotin Complex ABC) technique against IgG, IgA, IgM, IgE and C4 in skin tissue. Hypertrophic scars and keloids demonstrated over expression of IgG, IgA, IgM, and C4. These immunoglobulin were localized in a linear pattern along collogen bundles, and appeared very dense in scar nodules. IgE was located in mast cells, some in plasma cells, but in normal skin the expression of immunoglobulin was lower than that in scar tissue. so it was considered that immunoglobulin demonstrated in collagen fibers not only originated from circulation but also from the infected skin. These findings indicated that immunoglobulin is involved in the formation and progression of scars. It plays an important role in the formation of scar.