血管生成标志物在进行期银屑病皮损中的表达

Expression of angiogenesis markers in skin lesions of progressive psoriasis

目的探讨血管内皮生长因子(VEGF)、CD31和CD34在银屑病皮损组织中的表达情况及可能的致病机制。方法收集2018年3月—2020年5月在广州医科大学附属第五医院就诊的30例银屑病患者的临床资料及皮损处活组织,经临床、皮肤镜检查均处于疾病进行期,纳入银屑病组。另取曾在急诊科行清创术的10例患者的皮肤组织样本作为对照组。采用免疫组织化学染色法、实时荧光定量聚合酶链反应(PCR)和免疫印迹实验检测,比较VEGF、CD31和CD34在银屑病组织和正常皮肤组织中的表达情况。结果皮肤镜下银屑病组皮损组织的典型表现为亮红色背景上有银白色鳞屑,可见弥漫性分布的点状、小球状、肾小球样和环状血管。免疫组织化学染色示:CD31、CD34阳性染色位于银屑病组患者皮损处组织血管内皮细胞质中;VEGF在银屑病组患者的皮损组织中表达几乎遍布表皮全层,以棘层染色最强,主要表达于角质形成细胞质。与对照组相比,银屑病组患者皮损处组织的VEGF、CD31和CD34免疫组织化学染色评分均显著增加(P值均<0.05)。银屑病组患者皮损处组织中的VEGF、CD31和CD34的mRNA和蛋白质表达量均显著高于对照组(P值均<0.05)。结论VEGF、CD31和CD34蛋白在银屑病患者皮损处组织中高表达,且三者的表达具有一致性,在银屑病的病理演变过程中起着重要作用。

Objective To investigate the expression of VEGF,CD31 and CD34 in psoriasis skin lesions and the possible pathogenic mechanism.Methods Living tissues of skin lesion from 30 patients with psoriasis were collected from March 2018 to May 2020 in the Fifth Affiliated Hospital of Guangzhou Medical University.Clinical and dermoscopic examinations showed that the lesions were in the active stage,and the patients were enrolled into psoriasis group.Ten patients who underwent debridement in the emergency department of our hospital were taken as the controls,and dermoscopy was performed in them.Immunohistochemical staining,real-time fluorescent quantitative polymerase chain reaction(PCR)and Western blotting were used to detect the expression of vascular endothelial growth factor(VEGF),CD31 and CD34 in psoriasis tissues and normal skin tissues.Results The typical appearance of skin lesions under dermoscope in psoriasis group was a bright red background with white scales.Diffusely distributed dots,globules,glomeruli and ring blood vessels were visible.Immunohistochemical staining showed that CD31 and CD34 positive staining was located in the cytoplasm of vascular endothelial cells in the skin lesions of the psoriasis group,VEGF expression was almost all over the entire epidermis(especially in the spinous layer)and was mainly expressed in the cytoplasm of keratinocytes.Compared with the control group,the expression levels of VEGF,CD31 and CD34 in the skin lesions of the psoriasis group were significantly increased(all P<0.05).The mRNA and protein levels of VEGF,CD31 and CD34 in the skin lesions of the psoriasis group were significantly higher than those in the control group(all P<0.05).Conclusion VEGF,CD31 and CD34 proteins are highly expressed in the skin tissues of psoriasis patients,and their expressions were consistent,which play an important role in the pathological evolution of psoriasis.