Immune response induced by hematoporphyrin derivatives mediated photodynamic therapy:Immunogenic cell death and elevated costimulatory molecules

Photodynamic therapy(PDT)not only destroys tumor cells directly but also induced anti-tumor immune response through damage-associated molecular patterns(DAMPs).It is reported that anti-tumor response was associated with light dose and photosensitizer used in PDT.In this study,4T1 tumor cells were implanted on both the right and left flanks of mice.Only the right tumor was treated by HpD-PDT,while the left tumor was not irradiated.The anti-tumor immune response induced by HpD-PDT was investigated.The expression of DAMPs and costimulatory molecules induced by HpD-PDT were tested by immuno fluorescence and flow cytometry in vivo.Different light doses of PDT were designed to treat 4T1 cells.The killing effect was assessed by CCK-8 kit and apoptosis kit.The expression of DAMPs on 4T1 cells after HpDPDT were evaluated by flow cytometry,western blot and ATP kit.This study showed that CD4^(+)T,CD8^(+)T and the production of IFN-γwere increased significantly on day 10 in righttumor after PDT treatment compared with control group.HpD-PDT enhanced the expression of calreticulin(CRT)on tumor tissue.Importantly,co-stimulatory molecular OX-40 and 4-1BB were elevated on CD8^(+)T cells.In vitro,immunogenic death of 4T1 cells was induced after PDT.Besides,the expression of DAMPs increased with the increasing of energy density.This study indicates that anti-tumor immune effect was induced by HpD-PDT.The knowledge of the involvement of CRT,ATP and co-stimulatory molecules uncovers important mechanistic insight into the anti-tumor immunogenicity.It was the first time that co-stimulatory molecules were investigated and found to elevate after PDT.

THE SPECIFIC PHOTODYNAMIC EFFECTS OF MONOCLONAL ANTIBODIES CONJUGATED WITH HEMATOPORPHYRIN DERIVATIVE ON GASTRIC CANCER IN VITRO AND IN VIVO

Murine monoclonal antibody (MoAb) BB4.3, raised against the human gastric cancer cell line BGC823, was puriffied with Protein A-Sepharose CL-4B affinity chromatography and identified as IgG2a. It was then conjugated with a hematoporphyrin derivative (HPD) by using carbodiimide. The qualitative analysis of this conjugate showed that the amount of free HPD was negligible and there were no IgG aggregates among the conjugates. The conjugate retained both the antibody and photochemical activity of HPD.In vitro, the phototoxic effect of this HPD-BB4.3 conjugate on target cells was about 15 times higher than that of free HPD. The quality of selective photocytotoxicity was proven by the greater cytotoxi-city this conjugate showed than that of corresponding normal mouse IgG (NIgG) conjugated with HPD. It showed less cytotoxicity to colon cancer cell line B-80 (negative reaction to MoAb BB4.3) than to BGC825. Moreover, its cytotoxicity to BGC823 cells could be blocked specifically by excess BB4.3 antibody, but not by another MoAb 3G9, which combines with BGC823 at different binding sites from MoAb BB4.3.Nude mice inoculated with 2 × 10- BGC823 cells were given HPD-BB4.3, HPD, HPD-NIgG, HPD plus BB4.3 and PBS, respectively then exposed to light. Four out of six animals treated with the HPD-BB4.3 conjugate remained tumor-free for a long period. Although two developed tumors, there was a significant difference between the HPD-BB4.3-treated group and all the control groups in tumor induction time, tumor growth rate, and survival time (p<0.001). The HPD-BB4.3 conjugate inhibited the growth of established tumors by more than 40% in comparison with control groups (p<0.05).

The Observation of the Photodynamic Effect of Hematoporphyrin Derivative (HpD) Combined with Aidiron on Ascitic Hepatoma Cells in Vitro

In this study, we found, through biochemical synthesis of DNA with the incorporation of ~3HTdR and morphological observation of the tumor cells, that aidiron (912), an extract from earthworm, had a stronger kilting effect (27%) on mouse ascitic hepatoma tumor cells (H_(22)) in vitro, and that laser-hematoporphyrin derivative (HpD) combined with 912 markedly enhanced the kilting effect (74%) on tumor cells. By means of the fluoresoence spectrophotography we also dis- covered that the killing effect of laser-HpD-912 on tumor calls was closely related with the produc- tion of free radicals and lipid peroxidation.

Impact of the photosensitizers hematoporphyrin coated gold nanoparticles on biomphalaria alexandrina snails

The present study was done using two concentrations of the photosensitizer Hematoporphyrin coated Gold Nanoparticles (HpdGNP3) (5x10–6 , 5x10–5 mole/dicemeter–3), to evaluate their efficacy on survival rate, egg-laying capacity of Biomphalaria alexandrina snails and on histological deteriorations in their hermaphrodite gland. B. alexandrina snails were incubated for 12 hours at each tested concentration in the dark, thereafter they were exposed to direct sunlight (336.2 W/m2) for either 2 or 4 hours followed by 24 hours of recovery. Control snails were treated with these concentrations without exposure to light irradiance. Another experiment was carried out simultaneously and the snails were left for 4 weeks of recovery to evaluate their egg-laying capacity (Mx). The results indicate that 5x10–5 Mdm–3 (HpdGNPs) with 4 hours of exposure sunlight suppressed the survival rate of B. alexandrina snails by 50%. Meanwhile, control snails incubated with 5x10–5 Mdm–3 HpdGNPs were not affected and still alive (100%). For snail’s fecundity (Mx), treated snails laid low number of eggs throughout the recov-ery period (4 weeks), in comparison with that of control ones. The highest value of Mx for snails treated with 5x10–5 Mdm–3 Hpd coated GNPs was recorded at the 3rd week of recovery period, being 6.7 eggs/snail, compared to 37.6 eggs/control snail. This has a negative reflect on the reproductive rate (Ro) of treated snails as it was reduced under these conditions by 76.6% and 86.1%, respectively.Histological tests re-vealed injuries in spermatocytes, oocytes, several degenerations of B.alexandrina hermaphrodite gland then evacuations in many gonad’s cells which severely suppressed their capacity for egg-laying. It is concluded from the present work that exposing B. alexandrina snails to sublethal concentrations of the photosensiter Hpd coated GNPs (12 hours incubation, 4 hours exposure to 336.2 W/m2) significantly reduced their reproductive capacity that may have a negative reflect on schistosomiasis transmis-sion.

EFFECT OF HEMATOPORPHYRIN DERIVATIVE (HPD) PLUS LIGHT ON TRANSCRIPTION ACTIVITY IN THE NUCLEUS

To elucidate the mechanism of photodynamic damage of cells, the effect of HPD plus light on transcriptlonal ectlvlty In the mucleus Isolate from the normal rat liver was studied in vitor by 3H- UTP incorporation into RNA. Measurements of fluorescence spectrum showed that HPD was bound to the nucleus and its fluorescence Intensity Increased with the Increase of HPD concentration. The experimental results Indicated that no changes could be observed when either HPD or light was used alone. Whereas the nuclear transcription activity was found to be inhibited significantly by both HPD and light treatment, and the degree of Inhibition was dependent on the HPD concentration and the time of exposure to light. After treatment by 3 μg/ ml HPD, the inhibition rate of the nuclear transcription activity was 23% ,45% ,69% ,80% and 90%, respectively for light exposure of 2, 5, 10, 20 and 30 minutes. Our results suggested that dose-dependent decreases in the nuclear transcription activity, and marked inhibition of the activity was found in the range from 3 to 7 μg/ml HPD following exposure to light.

PURGE OF MALIGNANT CELLS FROM BONE MARROW BY HEMATOPORPHYRIN DERIVATIVES AND LIGHT EXPOSURE IN VITRO

During autologous bone marrow graft in treatment of malignant diseases, it is critical to purge malignant cells from the marrow. In the present study, the sensitivity to photodynamic inactivation of 3 leukemic cell lines was compared with their counterpart normal hematopoietic cells. After mouse leukemic L1210 cells were treated with a preparation of hematoporphyrin derivatives, YHpD, 10 μg/ml for 1 hr. and irradiated with blacklight (peak wavelength 395 nm, light intensity 0.6 mW/cm2) for 5 minutes, the survival rate of clonogenic cells decreased to <10%, while that of bone marrow granulocyte macrophage progenitor cells (CFU-GM) in DBA/2 mice remained at nearly normal level (>80%). Similar results were obtained when human leukemic HL-60 cells were compared with human CFU-GM and mouse leukemic L615 cells with CFU-GM in 615 strain mice. It is suggested that hematoporphyrin photoradiation may be useful for Iselectively killing leukemic cells in bone marrow.

Efficacy of Photogem（Hematoporphyrin Derivative） as a Photoactivatable Larvicide against Aedes aegypti （Diptera： Culicidae） Larvae

Dengue vector is responsible for millions of deaths every year and has caused disastrous impacts on health systems. The continuous use of chemical insecticides, such as carbamates, pyrethroids and organophosphates generates resistant populations of the mosquito, therefore, new control methods must be investigated. The joint action of the population and guidelines for preventing the reproduction of the mosquito associated with the use of photoactivatable insecticides can be the alternative for the control of epidemiological outbreaks in affected regions. In this study, the photo-larvicidal activity of Photogem^（PG）, a derivative of hematoporphyrin, was investigated against 2nd-early 3rd instar of Aedes aegypti larvae （Diptera： Culicidae） under different lighting conditions （artificial lighting system and sunlight）. The dynamics of PG accumulation was characterized by CLSM （confocal laser scanning microscopy） and total time PG eliminationin solution was investigated by ultraviolet-visible spectrophotometry. The maximum photo-activity of PG was observed in 0.5 h under sunlight exposure which achieved 100% larval mortality. Fluorescence images showed a uniform distribution of PG along the digestive tract. PG remained stable in the sunlight for 48 h and in an artificial lighting system for longer periods, therefore, it can be used for the control ofAedes aegypti larvae as a new alternative to chemical insecticides. The method is considered environmentally friendly due to its rapid degradation in the presence of light. Further studies are required, so that the potential of the technique can be explored in real breeding places.

Gold nanorods with a hematoporphyrin-loaded silica shell for dual-modality photodynamic and photothermal treatment of tumors in vivo

Nanocomposites （NCs） consisting of a gold nanorod core and a mesoporous silica shell doped with hematoporphyrin （HP） have been fabricated in order to improve the efficiency of cancer treatment by combining photothermal and photodynamic therapies （PDT ＋ PTT） in vivo. In addition to the long-wavelength plasmon resonance near 810-830 nm, the fabricated NCs exhibited a 400-nm absorbance peak corresponding to bound HP, generated singlet oxygen under 633-nm excitation near the 632.5-nm Q-band, and produced heat under a 808-nm near-infrared （NIR） laser irradiation. These modalities were used for a combined PDT ＋ PTT treatment of large （about 3 cm3） solid tumors in vivo with a xenorafted tumor rat model. NCs were directly injected into tumors and irradiated simultaneously with 633-nm and 808-nm lasers to stimulate the combined photodynamic and photothermal activities of NCs. The efficiency of the combined therapy was evaluated by optical coherence tomography, histological analysis, and by measurements of the tumor volume growth during a 21-day period. The NC-mediated PDT led to weak changes in tissue histology and to a moderate 20% decrease in the tumor volume. In contrast, the combined PDT ＋ PTT treatment resulted in the large-area tumor necrosis and led to dramatic decrease in the tumor volume.

Synergistic effects of focus ultrasound with different frequency and hematoporphyrin on human tumor cells

Human hematopoietic cell K 562 , human melenoma cell LiBr and human stomach cancer cells were exposed to ultrasound (US, 1.75 W/cm\+2, 1.4, 2.16 and 2.4 MHz) in vitro in the presence or absence of hematoporphyrin (Hp, 100 μg/mL). The cell damaging effects of treatments were determined by means of the Trypan Blue dye exclusion test, MTT test and FDA test. The experimental results showed that the same cell line had different sensibilities to the US of different frequencies, and different cell line had different damage at the same acoustical radiation. The combined treatment with US and Hp enhanced greatly the cell damage, and no sensibility of insonation cells to US with Hp was observed. The cell damage tests showed that the results of MTT test corresponded well with that of Trypan Blue dye test.

INQUIRY OF PHOTOSENSITIZATION MECHANISM OF YANGZHOU HEMATOPORPHYRIN DERIVATIVE(YHPD)

By the use of the advanced ESR technique and through comparing with BHPD, the characteristic of YHPD photosensitization is discussed in this paper in the respect of the primary process of photosensitization. The experiment results showed: (ⅰ) not only ~1O_2, but also free radicals(O_2· OH and YHPD)can be formed by the aid of YHPD; and (ⅱ) as to the ability of producing ~1O_2, YHPD<BHPD, while for generating O_2 and-OH, YHPD>BHPD. Two points are indicated: first, the photosensitized damage of YHPD is interrelated to not only ~1O_2, but also free radicals (O_2. OH and YHPD); second, although the photosensitized damage of YHPD is stronger than that of BHPD, yet the photosensitized damage is negatively correlated to the yield of ~1O_2 but positively correlated to those of O_2 and OH. Based on these two points, it is suggested that activated oxygen free radicals(O_2 and. OH) instead of ~1O_2 play the main role as instantaneously activated material in the photosensitized damage of YHPD.

NMR STUDY ON THE MAJOR COMPONENTS IN HEMATOPORPHYRIN DERIVATIVE YHPD

The hematoporphyrin derivative YHPD, a China-made product, has been clinically used in photodynamic therapy of tumors as a good photosensitizing drug. The NMR study on the structure of its major components is reported here. In terms of high performance liquid chromatography (HPLC) four major components A, B, C and D were isolated. The NMR results showed that the component A is O-acetylhematoporphyrin, B and C are two isomers of vinyldeuteroporphyrin. The spectra of 2-dimensional homonuclear correlation NMR, 2-dimensional NOE (nuclear overhauser enhancement), ^(13)C-NMR and off-resonance as well as FAB (fast atom bombarding) mass spectrum of component D indicate that it is a protoporphyrin dimer linked by carbon-carbon bond. This finding may providea chemical basis for understanding the difference in biological activity between YHPD and other foreign commercial HPD, as well as the composition of clincally used alkali-treated HPD and its effective component.

STUDIES ON THE EXPOSITION OF HYDROXYL RADICAL FROM HEMATOPORPHYRIN DERIVATIVE SOLUTION TO LIGHT BY SPIN-TRAPPING METHOD

That the photosensitive action of hematoporphyrin can damage tumor cells, has attracted much attention recently. However, its mechanism of action is not very clear. Some reported that the damage is due to the production of singlet oxygen （1O2）, a cy-

TIME-RESOLVED FLUORESCENCE SPECTROSCOPY OF HEMATOPORPHYRIN DERIVATIVE LASER No. 3

Ⅰ. INTRODUCTIONPhotodynamic therapy (PDT) which utilizes hematoporphyrin derivative (HpD) as a photosensitizing drug has increasingly being used for the local treatment of malignant tumors. The success of this method is attributed to the ability of HpD to accumulate to

THE ELECTRON SPIN RESONANCE STUDY ON PRIMARY PHOTOCHEMICAL REACTION OF HEMATOPORPHYRIN DERIVATIVE

The rate of oxygen consumption and the yield of free radical anion of hematoporphyrin derivative (HPD) in aqueous solutions of HPD and pyrocatechol were measured by the probe 2,2,6,6-tetramethyl4-piperidone-1-oxyl.It has been found that both singlet oxygen and free radical mechanisms exist simultaneously in primary photochemical reactions, and there is a competition between both mechanisms. When the oxygen concentration in solutions comes down to 12-14% of the stanting level, the predominant mechanism can be changed from the singlet oxygen to the free radical.Whether HPD exists in aggregation state is very important to photosensitization mechanisms.In the presence of the aggregation state of HPD, the predominant mechanism is the free radical,and photosensitization effects of HPD are all the better.

声致相变纳米探针用于瘢痕疙瘩成纤维细胞级联疗法的实验研究

目的制备一种新型脂质载药纳米探针HD@P-NPs,探讨其体外超声成像效果及用于瘢痕疙瘩成纤维细胞(KFs)迁移抑制和级联放大治疗的效果。方法采用超声乳化法制备以全氟乙烷为核心脂质壳层,负载血卟啉单甲醚和阿霉素的脂质载药纳米探针HD@P-NPs,观察其形态、结构并检测粒径和Zeta电位,计算药物包封率和载药率;进一步观察HD@P-NPs在低强度聚焦超声(LIFU)辐照下的二维超声及超声造影成像效果;溶血实验检测HD@P-NPs在不同浓度下的溶血率。取对数生长期的瘢痕疙瘩KFs按照不同实验条件培养,并分为5组:对照组(不予特殊处理)、LIFU辐照组、D@P-NPs组(仅加入阿霉素)、HD@P-NPs组、HD@P-NPs+LIFU辐照组,使用MTT法检测各组细胞存活率;Calcein AM/PI染色观察各组细胞活性;细胞迁移实验检测各组细胞迁移率;活性氧荧光染色观察各组活性氧产生情况,获取其荧光强度。结果成功制备HD@P-NPs,呈球形且大小均一,平均粒径(170.36±6.03)nm,平均Zeta电位(-36.91±3.56)mV;血卟啉单甲醚包封率和载药率分别为67.41%、5.18%,阿霉素包封率和载药率分别为72.80%、11.20%。LIFU辐照后,HD@P-NPs相变产生微气泡,在3 W/cm^(2)、2 min辐照条件下可实现最佳成像效果,后续实验采用此辐照条件。HD@P-NPs在25、50、100、200μg/ml浓度下的溶血率分别为(2.48±0.02)%、(4.87±0.06)%、(5.03±0.03)%、(6.10±0.04)%。对照组、LIFU辐照组、D@P-NPs组、HD@P-NPs组及HD@P-NPs+LIFU辐照组细胞存活率分别为100%、(96.87±0.71)%、(77.94±2.83)%、(77.11±3.53)%、(49.75±1.25)%,HD@P-NPs+LIFU辐照组与对照组细胞存活率比较差异有统计学意义(P<0.05)。HD@P-NPs+LIFU辐照组见明显红色荧光及少量绿色荧光。对照组、LIFU辐照组、D@P-NPs组、HD@PNPs组、HD@P-NPs+LIFU辐照组的细胞迁移率分别为(29.96±3.20)%、(28.62±2.56)%、(18.13±0.89)%、(17.46±0.20)%、(10.04±1.62)%,其中HD@P-NPs+LIFU辐照组细胞迁移率低于其余各组,差异均有统计学意义(均P<0.05)。HD@PNPs+LIFU辐照组活性氧荧光强度为22.43±3.10,与其余各组比较差异均有统计学意义(均P<0.05)。结论本实验成功制备了HD@P-NPs,其在LIFU辐照下可提高靶区有效药物浓度,具有较好的体外超声成像效果,可实现超声可视化瘢痕疙瘩KFs级联放大治疗。

光动力疗法治疗鲜红斑痣1216例临床分析

目的 分析比较血啉甲醚 (HMME)与血卟啉衍生物 (HpD)为光敏剂行光动力治疗 (PDT)鲜红斑痣的临床疗效及副反应。材料与方法 鲜红斑痣患者 12 16例 ,粉红型 13 2 % ,紫红型 6 8 3% ,增厚型 18 4%。静脉注射HpD或HMME 3～ 7mg/kg后给予铜蒸气激光、KTD/ 5 32激光或氩离子激光照射 ,功率密度 5 0～ 10 0mW/cm2 ,能量密度 90～ 5 40J/cm2 ,随访观察。结果 HMME PDT和HpD PDT对各型鲜红斑痣均能有效地消除病变颜色 ,所随访的 16 32个病灶在 2个月至 9年的随访期内未见复发。治疗后反应有 :局部水肿 5～ 7天 ,部分患者有结痂或一过性色素沉着 ,皮肤暂时性光过敏反应。HpD PDT组避光期 30～ 90天 ,HMME PDT组避光期 7～ 14天。与HpD PDT相比 ,HMME PDT具有反应轻、愈合快、不良反应少、安全度大、避光期短、色素沉着轻、护理容易、重复治疗间隔期短的特点。结论 HMME PDT与HpD PDT都能有效治疗各型鲜红斑痣 ,但HMME PDT具有不良反应少、安全度大、避光期短、护理容易。

光动力疗法治疗鲜红斑痣的基础研究——血啉甲醚与血卟啉衍生物吸收特性的比较

目的 观察新型光敏剂———血啉甲醚 (HMME)在鸡冠皮肤组织和血管内皮细胞 (EC)的吸收特点。方法 莱亨鸡 12只 ,分为HMME组和血卟啉衍生物 (HpD)组 ,每组 6只。分别静脉注射HMME或HpD10mg kg ,每隔 10min取血 2 5ml和鸡冠皮肤组织 2 5g。培养新生儿脐带EC ,培养液中加入HMME或HpD ,孵育浓度分别为 2 0、40、6 0、80和 10 0μg ml,孵育时间为即刻、15、30、6 0、12 0、180和 2 40min。采用荧光分析法测定光敏剂含量 ,并绘制EC吸收光敏剂的浓度—含量和时间—含量关系曲线。结果 静脉注射HMME或HpD后 ,其血清浓度的峰值出现在注射后 10min ,以后随时间迅速下降 ,二者的曲线形态基本一致。HMME在鸡冠组织中的含量于注射后 10min显著高于HpD(P <0 0 1) ,以后虽然下降速率较快 ,但在注射后 80min仍显著高于HpD(P <0 0 5 )。培养EC可迅速吸收HMME和HpD ,30min达峰值的 89%以上 ;其吸收量与孵育浓度呈线性关系 ,对HMME的吸收量显著高于HpD(P <0 0 1)。结论 HMME较HpD更容易被皮肤微血管EC摄取 。

声化学激活血卟啉诱导艾氏腹水肿瘤细胞凋亡

本实验采用频率为 2 0MHz,声强分别为 1 0W/cm2 、 1 5W /cm2 、 2 0W /cm2 等不同参数 ,研究超声激活血卟啉对艾氏腹水肿瘤细胞的杀伤作用和诱导肿瘤细胞凋亡现象。通过扫描电镜、透射电镜以及荧光显微镜观察受损后细胞形态结构的变化 ,主要表现为细胞微绒毛的减少 ,胞膜结构和通透性的改变 ,细胞器的受损以及核物质的分解、丢失 ;同时发现处理后的肿瘤细胞有核物质凝集、趋边排列以及凋亡小体的形成等细胞凋亡特征。研究中首次发现声化学激活血卟啉在对艾氏腹水肿瘤细胞杀伤的同时 ,也能诱导艾氏腹水肿瘤细胞发生凋亡 。

声化学诱导艾氏腹水瘤细胞凋亡机制初探

本研究采用频率1.43MHz,声强3W/cm2的高频聚焦超声处理艾氏腹水肿瘤细胞,研究超声激活血卟啉诱导艾氏腹水肿瘤细胞凋亡的途径及其与癌细胞内的氧自由基之间的关系。通过细胞免疫组织化学方法检测与癌细胞凋亡相关的Bax,细胞色素c和caspase-3蛋白的动态表达,黄嘌呤氧化酶法检测超氧化物歧化酶活性变化,硫代巴比妥酸法检测膜脂质过氧化物的含量。结果发现超声加血卟啉处理1h,癌细胞胞浆中的三种促凋亡蛋白表达增多,3h时表现为高表达;处理1h的癌细胞,超氧化物歧化酶活性下降,膜脂质过氧化物增多。研究结果表明超声激活血卟啉诱导艾氏腹水肿瘤细胞凋亡可能通过线粒体途径,且与癌细胞受损后产生的氧自由基有关。

血啉甲醚与血卟啉衍生物对鸡冠皮肤光敏损伤特点的比较研究

目的 采用形态学方法观察比较国产新型光敏剂———血啉甲醚 (HMME)与传统光敏剂———血卟啉衍生物 (HpD)对鸡冠表皮层、真皮乳头层毛细血管网、乳头下网状层和真皮深层组织的光敏损伤特点。方法 成年莱亨鸡 2 34只 ,随机分为对照组 42只 ,实验组 192只。实验组动物静脉注射HMME或HpD 1、5、10或 2 0mg/kg ,于给药后即刻、1、2、3或 4h对鸡冠进行激光照射 ,波长为 488 0和 5 14 5、5 10 6、5 78 2或 6 2 7 8nm ,功率密度为 5 0、10 0或 15 0mW/cm2 ,能量密度为 30、6 0、90、12 0、15 0、180或 2 70J/cm2 ,于照射后即刻、1、3、7、14和 2 8天取材 ,进行大体和光镜观察。结果 PDT作用区的红色鸡冠完全变白 ,乳头层毛细血管网内皮细胞 (EC)坏死、管壁破坏及血管数量减少 ,其作用程度与光敏剂给药量和激光照射量相关。HMME和HpD对乳头层毛细血管网的损伤程度相似 ;HMME组未见表皮及乳头下各层损伤 ,而部分HpD组见表皮基底细胞层有局灶性坏死、乳头下网状层有微血管及结缔组织损伤和淋巴细胞浸润。结论 HMME和HpD对鸡冠真皮乳头层毛细血管网的损伤程度相似 ,但HMME的组织选择性优于HpD。