The phenotypic profile of dermatomyositis and lupus erythematosus: a comparative analysis
The phenotypic profile of dermatomyositis and lupus erythematosus: a comparative analysis
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DOI：
10.1111/j.1600-0560.2009.01443.x
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发表时间：
2010-06-01
影响因子：
1.7
通讯作者：
Chadwick, Paul
中科院分区：
文献类型：
--
作者：
Magro, Cynthia M.;Segal, Jeremy P.;Chadwick, Paul
背景：皮肌炎(DM)患者皮损中CXCR3+淋巴细胞的I型干扰素相关募集是近年来研究的热点。方法：对42例系统性红斑狼疮(SLE)、盘状红斑狼疮(DLE)和亚急性皮肤型红斑狼疮(SCLE)患者的皮损进行表型分析，探讨表型分析在胶原血管病变亚型分类中的应用价值。DM的主要单个核细胞表现为CD4/CXCR3阳性，而SLE的活检组织中典型地显示CXCR3阳性细胞的稀少。CD8和CD20淋巴细胞分别在SLE和DLE中最大。CD123浆细胞样树突状细胞在SCLE中最常见，CD83表达极少。内皮型MXA表达是DM的特征。CD123和Mxa在界面损伤区的炎症细胞和角质形成细胞中的表达最为明显。皮肤淋巴细胞抗原(CLA)在大多数DM和LE患者真皮浸润物中表达减弱。T调节细胞从未超过浸润液的15%，在DM和LE的情况下最少。结论：干扰素α诱导的细胞因子环境在SLE、DLE、SCLE和DM中普遍存在。此外，上面提到的表型差异可能对分离这些不同的亚集具有一定的实用价值。糖尿病的MXA血管内皮细胞染色和胶原血管病变中CD83和CLA缺乏染色等以前未被强调的特征可能具有诊断价值。
Background: The mechanisms which regulate cutaneous inflammation in the setting of collagen vascular disease have been a topic of recent interest; emphasis has been placed on type I interferon-associated recruitment of CXCR3+ lymphocytes in dermatomyositis (DM).Methods: On a total of 42 biopsies from patients with DM, systemic lupus erythematosus (SLE), discoid lupus erythematosus (DLE) and subacute cutaneous lupus erythematosus (SCLE) comprehensive phenotypic studies were performed to explore the practical value of phenotypic analysis in the subclassification of lesions of collagen vascular disease.Results: The infiltrate in DM was of mild intensity compared to lupus erythematosus (LE). The dominant mononuclear cell in DM exhibited a CD4/CXCR3-positive phenotype while biopsies of SLE typically showed a dearth of CXCR3-positive cells. CD8 and CD20 lymphocytes were greatest in SLE and DLE, respectively. CD123 plasmacytoid dendritic cells, seen in most cases, were most frequent in cases of SCLE; CD83 expression was minimal. Endothelial MXA expression was a characteristic feature of DM. CD123 and MXA expression within inflammatory cells and keratinocytes was most conspicuous in areas of interface injury. Cutaneous lymphocyte antigen (CLA) expression was diminished in the dermal infiltrate in most cases of DM and LE. T regulatory cells never exceeded 15% of the infiltrate and were the least in the setting of DM and LE.Conclusions: An interferon-alpha-inducible cytokine milieu is common in SLE, DLE, SCLE and DM. In addition, there are phenotypic differences as alluded to above that may be of some practical value in separating these distinctive subsets. Features not previously emphasized such as MXA endothelial cell staining in DM and the lack of staining for CD83 and CLA in lesions of collagen vascular disease may be of diagnostic value.