乙酰胆碱受体在天疱疮患者体内的表达

The expression level of acetylcholine receptor in the patients with pemphigus

目的:研究不同型别天疱疮患者体内乙酰胆碱受体的表达状况,初步探讨其与病情活动度和天疱疮分型的关系。方法:主要采用免疫组化和ELISA方法。结果:乙酰胆碱受体IgG(acetylcholine receptor IgG,AChR IgG)在30例天疱疮患者中有8例患者为阳性,7例为寻常型天疱疮,1例为落叶型天疱疮,与正常对照组比较,差异没有统计学意义(P>0.05);在AChRIgG阳性的患者中,病情分级较重,当病情得到有效控制后,外周血AChR IgG的吸光度(A)值下降。AChRM3亚型在寻常型天疱疮中褐色的颗粒仍然分布在基底层,但颜色加深,颗粒变大,且大小不一致。AChRM3亚型在落叶型天疱疮中的表达模式与正常对照组无统计学差异。AChRα亚基在寻常型天疱疮和落叶型天疱疮中褐色的颗粒仍然分布在全层,但颜色加深-颗粒变大,且大小不一致。结论:在落叶型天疱疮和寻常型天疱疮中,AChR抗体的表达状况不同。AChR抗体更易出现在桥粒芯糖蛋白(Dsg)3抗体阳性患者的外周血中,在Dsg3阳性患者皮损的组织切片中,除了AChRα蛋白之外,AChRM3蛋白的染色模式也发生了改变。这提示Dsg3抗体更易导致AChR途径的异常。

Objective： To study the expression of the acetylcholine receptor in different types of pemphigus patients,and in- vestigate the relationship between the expression and disease activity of different types of pemphigus. Methods： Immunohistochemistry and ELISA were used. Results： In a total of 30 patients, the OD value of AChR IgG in peripheral blood was positive in 8 patients, among them 7 cases were pemphigus vulgaris patients and 1 pemphigus foliaceus. There was no statistical difference （P〉 0.05） compared with normal controls. In the AChR-positive patients, the disease was more severe. The OD value of AChR IgG in peripheral blood declined after the disease was under control. In pemphigus vulgaris, subtype AChRM3 distributed in the basal layer as brown granules with deep color and larger particles with different sizes. The expression of AChRM3 in pemphigus foliaceus showed no significant difference compared with that of normal controls. In pemphigus vulgaris and pemphigus foliaceus, subunit AChRα was distributed in the whole layer as brown granules with deep color and larger particles with different sizes. Conclusion： In pemphigus vulgaris and pemphigus foliaceus, AChR antibody expression levels are different. AChR antibody is more likely to appear in the peripheral blood of Dsg3-positive patients. In the skin biopsy of Dsg3-positive patients, the staining patterns of both AChRα protein and AChRM3 protein have changed. This shows that the Dsg3 antibodies are more likely to lead to abnormal AChR pathway.