MICROVASCULAR CHANGES IN EARLY AND ADVANCED DERMATOMYOSITIS - A QUANTITATIVE STUDY
MICROVASCULAR CHANGES IN EARLY AND ADVANCED DERMATOMYOSITIS - A QUANTITATIVE STUDY
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DOI：
10.1002/ana.410270402
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发表时间：
1990-04-01
影响因子：
11.2
通讯作者：
ENGEL, AG
中科院分区：
文献类型：
--
作者：
EMSLIESMITH, AM;ENGEL, AG
在成人皮肌炎10肌肉标本没有或最小的组织学改变进行了比较，显示典型的改变7。来自包涵体肌炎患者的5个标本、来自多发性肌炎患者的5个标本和来自正常受试者的8个标本作为对照。血管内皮细胞，可视化与凝集素荆豆凝集素I，补体膜攻击复合物在相同的冷冻切片配对免疫荧光。分析大的随机选择的区域，以确定每平方毫米纤维面积的毛细血管数（毛细血管密度）、每1，000 μ m2面积的每种肌纤维的毛细血管数（毛细血管指数）和100 × 10 - 6的每种肌纤维的毛细血管数。100 μ m网格正方形。在皮肌炎标本与最小的结构改变有局灶性毛细血管枯竭，毛细血管密度显着降低，毛细血管指数和网格计数的频率分布向左移动。在晚期皮肌炎标本中，结果相似，但更严重。在这两种标本中，毛细血管簇反应补体膜攻击复合物。膜攻击复合体阳性血管比例最高的2例患者具有暴发性和致死性病程。在多发性肌炎和包涵体肌炎标本中，毛细血管具有正常的整体密度，没有对膜攻击复合物的反应。这些发现暗示毛细血管是皮肌炎疾病过程的早期和特异性靶点。
In adult dermatomyositis 10 muscle specimens with no or minimal histological alterations were compared with 7 that showed typical alterations. Five specimens from patients with inclusion body myositis, 5 from patients with polymyositis, and 8 from normal subjects served as controls. Vascular endothelium, visualized with the lectin Ulex europaeus agglutinin I, and complement membrane attack complex were demonstrated in the same cryostat sections by paired immunofluorescence. Large randomly selected fields were analyzed to determine the number of capillaries per square millimeter of fiber area (capillary density), per 1,000-.mu.m2 area of each muscle fiber (capillary index), and in 100 .times. 100-.mu.m grid squares. In dermatomyositis specimens with minimal structural alterations there was focal capillary depletion, the capillary density was significantly reduced, and the frequency distributions of the capillary index and grid count were shifted to the left. In advanced dermatomyositis specimens, the findings were similar but more severe. In both kinds of specimens, clusters of capillaries reacted for complement membrane attack complex. The 2 patients with the highest proportion of vessels positive for membrane attack complex had a fulminant and fatal course. In polymyositis and inclusion body myositis specimens, the capillaries had a normal overall density and none reacted for membrane attack complex. The findings imply that the capillaries are an early and specific target of the disease process in dermatomyositis.