皮肤扁平疣自体植入疗法疣体脱落的病理及免疫学基础

Pathological and Immunohistochemical Study of Self-activated Immunity against Verruca Plana

为探讨扁平疣自体植入疗法疣体脱落的病理及免疫学基础，对反应期疣体进行了常现HE染色（7例）和免疫组织化学标记（6例）。结果显示：病理组织学改变（1）疣体反应区淋巴细胞浸润，同时伴棘细胞水肿、溶解；（2）未见急性炎细胞浸润及坏死细胞残骸，未见单核巨噬细胞聚集及其吞噬现象；（3）真皮层血管扩张充血不明显。免疫学特征（1）反应区浸润的淋巴细胞显示CD45RO＋、CD6＋、CD4＋、CD8＋、CD20-、Mac387－；（2）表皮基底层及反应区见S－100蛋白阳性的郎格罕细胞。表明扁平疣脱落的病理和免疫学基础是T细胞介导的免疫反应，主要是CD8＋亚群参与的细胞毒作用，疣体的脱落是由于CD8＋对靶细胞直接杀伤，使细胞溶解坏死所致；表皮内S－100蛋白的郎格罕细胞充当抗原递呈细胞。

To investigate the histopathological and immunohistochemical features of self-activated immunity of varruca plana, 6cases of varruca plana at various reaction stages after autoimplantation of wart tessue were studied by H.E stain and immunohistchemical techniques. The pathological changes were as follows:1) Lymphocyte infiltration , cellular edema and dissolution were found in the reaction areas;2) No infiltration of acute inflammation cell , remains of necrotic cell and gathering or phagocytation of macrophages were found ;3) There were no significant vascular dilatation and hyperaemia in the dermis. The Immunohistochemical features included these:1) The infiltrated lymphocytes shown UCHL1 +, CD6+, CD4+, CD8+, L26-and Mac387-;2)Langerhans' cells with S-100 protein positive were found in stratum basale of epidermis and the reaction area. It is concluded that self-activated immunity of verruca Plana is T-cell mediatded specific immune response. It is mainly CD8 + subpopulation mediated cytotoxic effect .The cause of detachment of verrucal plana is that target cells are killed and rejected by CD8+, and Langerhans cells Play the part of antigen presenting cell.