大疱性类天疱疮患者血清及疱液嗜酸性粒细胞阳离子蛋白水平检测

Detection of eosinophil cationic protein in sera and blister fluids of patients with bullous pemphigoid

目的探讨血清及疱液嗜酸性粒细胞阳离子蛋白(ECP)水平与大疱性类天疱疮(BP)的关系。方法选择2012年1月至2019年10月在北京协和医院皮肤科就诊的初发BP患者40例、健康人40例进行血清ECP检测;选择同一时期就诊的33例初发BP患者、41例非免疫性疱病患者进行疱液ECP检测。用酶联免疫吸附实验检测血清和疱液ECP含量,同时对1例BP和1例接触性皮炎患者皮损部位病理切片进行ECP免疫组化染色。符合正态分布的两组间数据比较采用t检验或t′检验,计数资料的比较采用χ2检验。采用Pearson相关系数分析BP患者血清ECP与外周血嗜酸性粒细胞之间的关系。结果BP组血清ECP含量为(116.9±19.3)ng/L,健康对照组为(93.3±15.9)ng/L,差异有统计学意义(t=5.96,P<0.001)。BP组疱液ECP含量为(665.8±189.0)ng/L,非免疫性疱病组为(547.5±240.6)ng/L,差异有统计学意义(t=2.31,P=0.02)。免疫组化结果显示,BP患者ECP阳性细胞胞质棕黄色颗粒明显多于接触性皮炎患者。BP患者血清ECP与外周血嗜酸性粒细胞比例之间无统计学相关性(r=-0.15,P=0.35)。结论BP患者血液、疱液ECP水平明显升高,且疱液ECP水平远远高于血清ECP水平,提示ECP可能参与BP的发病过程。

Objective To investigate the relationship of eosinophil cationic protein(ECP)levels in sera and blister fluids with bullous pemphigoid(BP).Methods From January 2012 to October 2019,40 patients with newly diagnosed BP and 40 healthy individuals were enrolled from Department of Dermatology,Peking Union Medical College Hospital,and serum ECP levels were detected by enzyme-linked immunosorbent assay.Meanwhile,another 33 patients with newly diagnosed BP and 41 patients with non-autoimmune bullous diseases were enrolled,and the ECP level was detected in blister fluids by enzyme-linked immunosorbent assay.Pathological sections of skin lesions of 1 patient with BP and 1 with contact dermatitis were subjected to immunohistochemical staining for ECP.Normally distributed data were compared between 2 groups by using t test or t′test,while enumeration data were compared by using chi-square test.Pearson′s correlation coefficient was used to analyze the relationship between serum levels of ECP and proportions of peripheral blood eosinophils in patients with BP.Results The serum level of ECP was significantly higher in the BP group(116.9±19.3 ng/L)than in the healthy control group(93.3±15.9 ng/L,t=5.96,P<0.001),and the blister fluid level of ECP was also significantly higher in the BP group(665.8±189.0 ng/L)than in the non-autoimmune bullous disease group(547.5±240.6 ng/L,t=2.31,P=0.02).Immunohistochemical study showed more brown-yellow particles in the cytoplasm of ECP-positive cells in the BP group than in the contact dermatitis group.There was no significant correlation between the serum level of ECP and proportion of peripheral blood eosinophils in the BP patients(r=-0.15,P=0.35).Conclusion The levels of ECP in the sera and blister fluids markedly increased in the patients with BP,and blister fluid levels of ECP were much higher than serum levels of ECP,suggesting that ECP may be involved in the occurrence of BP.