红斑狼疮皮损中浸润细胞免疫表型和角质形成细胞HLA-DR抗原表达的研究

Study on components of dermal infiltrating cells and expression of HLA DR antigens on keratinocytes in LE skin lesions

应用抗ＨＬＡＤＲ、ＣＤ３、ＣＤ４、ＣＤ８、ＣＤ２０的单克隆抗体和ｓｔｒｅｐｔｒａｖｉｄｉｎｐｅｒｏｘｉｄａｓｅｓｔａｉｎｉｎｇ（ＳＰ）技术对１０名正常人皮肤，１６例ＳＬＥ皮损和１９例ＤＬＥ皮损进行了免疫组化研究。观察到正常人皮肤角质形成细胞未见ＨＬＡＤＲ抗原表达，而ＳＬＥ（６／１６），ＤＬＥ（８／１９）皮损处角质形成细胞可以表达ＨＬＡＤＲ抗原。在ＳＬＥ、ＤＬＥ真皮内浸润细胞主要为Ｔ淋巴细胞（ＣＤ３＋浸润细胞），且以ＴＨ细胞（ＣＤ４＋浸润细胞）占优势。另外，还发现在两种ＬＥ表皮角质形成细胞表达ＨＬＡＤＲ抗原处，真皮内可见ＣＤ３＋浸润细胞和激活的Ｔ淋巴细胞（ＨＬＡＤＲ＋浸润细胞）。讨论了ＬＥ皮损角质形成细胞ＨＬＡＤＲ抗原表达及其与病损内浸润细胞免疫表型的关系。ＬＥ皮损处ＨＬＡＤＲ＋角质形成细胞可能具有抗原递呈作用，而角质形成细胞异常表达ＨＬＡＤＲ抗原则可能与真皮内浸润单个核细胞或淋巴细胞释放的ＩＦＮα，ＴＮＦγ等有关。

To investigate the expression of HLA DR antigens on lesional keratinocytes in LE, and its relationship with the dermal infiltrating cells in LE lesions, HLA DR, CD3,CD4,CD8,CD20 monoclonal antibodies and streptravidin peroxidase staining technique were employed. The results showed that the expression of HLA DR antigens on lesional keratinocytes (KCs) could be observed in SLE (6/16) and DLE (8/19), but not in normal skin . Most of the keratinocytes expressing HLA DR antigens were basal cells. In addition, 51%～54%of mononuclear cells (MNC) infiltrating in superficial dermis were found to be T lymphocytes (CD3+cells), and CD4+lymphocytes which were more than CD8+lymphocytes among the CD3+T lymphocytes. 29%～30%of dermal infiltrating cells were HLA DR+lymphocytes (activated cells). The numbers of CD3+, CD4+, CD8+and HLA DR+cells were significantly higher in LE than in normal skin(P< 0 05). There were no significant differences in CD20+cells among the three groups. The results indicate that keratinocytes may have antigen presenting function and the T lymphocytes might play a significant role in mediating the inflammatory reaction in LE lesions.