8-甲氧补骨脂素和长波紫外线光化学疗法对皮肤光老化的影响

Influences of photochemotherapy with psoralen and ultraviolet A on skin photoaging

目的 探讨 8 甲氧补骨脂素和长波紫外线 ( psoralenandultravioletA ,PUVA)光化学疗法对皮肤光老化影响及其可能机制。方法 采用HE染色、Verhoeff染色、电镜、酶组织化学、免疫组织化学等方法检测PUVA治疗对银屑病背部非皮损区皮肤真皮基质、成纤维细胞表型、衰老相关 β半乳糖苷酶(SA β Gal)和 p16蛋白表达的影响。 结果 PUVA治疗后 ,银屑病患者背部非皮损区皮肤真皮变性胶原、弹力纤维增多 ,排列紊乱 ;真皮成纤维细胞由分裂表型转化为无分裂活性表型 ;B组和A组的SA β Gal表达阳性率分别为 13 .6%、0 .0 0 % ,p16蛋白表达阳性率分别为 81.8%、42 .9% ,两组两项指标比较均有显著性差异 ( χ2 =2 1.412 ,P <0 .0 0 1,χ2 =4.0 3 5 ,P <0 .0 5 )。结论 PUVA可诱导寻常型银屑病患者背部非皮损区真皮迅速出现具有光老化特征性的组织学及生物学特性改变 。

Objective To investigate the influences of photochemotherapy with psoralen and ultraviolet A (PUVA) on skin photoaging and its possible mechanism. Methods HE stain, Verhoeff stain, electron microscopy, enzyme cytochemistry and immunocytochemistry were used to study influences of PUVA on the skin photoaging with characteristic biological markers in the non-lesion back skin of patients with psoriasis vulgaris. Results After treatment with PUVA, the degenerated collagen and elastic fibers were increased with derangement profile in dermis, and fibroblasts displayed growth suppression and morphological changes of cell senescence with a permanent switch of mitotic to stably postmitotic phenotypes, of group B and group A, the positive rates of SA-β-Gal were 13.6 % and 0.00 % and the positive rates of p16 protein were 81.8 % and 42.9 % respectively, there were significant differences between group B and group A(χ 2=21.412, P<0.001,χ 2=4.035, P<0.05). Conclusion PUVA treatment can induce the dermis of uninvolved skin in the back to appear characteristic changes of photoaging rapidly in patients with psoriasis vulgaris. Its mechanism may be closely related to specific morphologic and functional changes of dermal fibroblasts.