Periostin/TSLP在慢性瘙痒患者皮肤组织中的表达研究

Expressions of periostin and TSLP in the skin of patients with chronic pruritus

目的:通过分析慢性瘙痒患者皮损区病理变化,研究骨膜蛋白(periostin)和胸腺基质淋巴蛋白(thymic stromal lymphopoietin,TSLP)在慢性瘙痒中的作用。方法:收集2014年12月至2016年12月42例皮肤瘙痒超过6周的患者的皮损组织和23例正常人的皮肤标本。用苏木精-伊红(hematoxylin-eosin staining,HE)染色检测患者皮肤组织病理结构的变化。用免疫组化(immunohistochemistry,IHC)染色检测皮肤组织中periostin和TSLP的表达。比较2组间表皮增厚程度以及periostin、TSLP蛋白表达水平的差异。结果:HE染色结果显示,与对照组相比,患者皮损处表皮明显增厚[(477.70±14.89)μm vs.(94.28±6.58)μm,t=40.800,P=0.000],角质层角化不全伴角化过度,同时真皮内可见炎性细胞浸润。IHC染色显示,与对照组相比,慢性瘙痒组periostin[(7.33±3.20)vs.(0.65±0.65),t=13.060,P=0.000]和TSLP[(8.48±2.60)vs.(0.61±0.66),t=18.580,P=0.000]的表达量均明显增高。Periostin在皮损组织中主要表达于真皮层、毛囊外和皮脂腺外,而TSLP主要表达于表皮层、毛囊内部和皮脂腺内部。结论:Periostin/TSLP介导的Ⅱ型辅助性T细胞(T help cell 2,Th2)型免疫应答参与慢性瘙痒的发生发展过程。

Objective：To investigate the roles of periostin and thymic stromal lymphopoietin（TSLP）in chronic pruritus by analyzing the pathological changes of the skin lesions. Methods：Samples of skin lesions from 42 patients with skin pruritus over 6 weeks and samples of normal skin from 23 general persons were collected from December 2014 to December 2016. The histopathological changes of the samples were detected by the hematoxylin-eosin（HE）staining,and the expressions of periostin and TSLP in skin tissues by the immunohistochemistry（IHC）. Then the thickness of epidermis and the expressions of periostin and TSLP were compared between the two groups. Results：HE staining showed that the epidermis in patients thickened significantly compared with that in the control [（477.70±14.89）μm vs.（94.28±6.58）μm,t=40.800,P=0.000]. In skin lesion samples,parakeratosis and hyperkeratosis were observed in the stratum corneum,and the infiltration of the inflammatory cells was observed in the dermis. IHC staining showed that the expressions of periostin and TSLP in chronic pruritus group were significantly higher than those in the control group respectively[（7.33±3.20）vs.（0.65±0.65）,t=13.060,P=0.000] and [（8.48±2.60）vs.（0.61 ±0.66）,t =18.580,P =0.000].Specifically,periostin was mainly expressed in the dermis,outside of the hair follicles and sebaceous glands,while TSLP was mainly expressed in the epidermis,inside of the hair follicles and sebaceous glands. Conclusion：Periostin/TSLP-mediated T help cell 2（Th2）type immune response is involved in the pathogenesis and development of chronic pruritus.