Detection of multinucleated giant cells in differentiated keratinocytes with herpes simplex virus and varicella zoster virus infections by modified Tzanck smear method
Detection of multinucleated giant cells in differentiated keratinocytes with herpes simplex virus and varicella zoster virus infections by modified Tzanck smear method
复制标题
改良Tzanck涂片法检测单纯疱疹病毒和水痘带状疱疹病毒感染的分化角质形成细胞中的多核巨细胞
DOI：
10.1111/1346-8138.15619
复制
发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Aoyama Yumi
中科院分区：
文献类型：
--
作者：
Yamamoto Takenobu;Aoyama Yumi
单纯疱疹病毒（HSV）和水痘带状疱疹病毒（VZV）感染诱导表皮内囊泡的形成，表皮内囊泡含有棘溶细胞和多核巨细胞。zanck涂片是最常用于诊断皮肤疱疹感染，但它会导致许多假阳性和假阴性结果。本研究旨在建立一种使用Tzanck涂片检测更大的多核巨细胞的方法，因为这些细胞表征了皮肤感染中的病毒细胞病变效应。在临床和体外实验中，我们分析了HSV -或VZV -相关皮肤病变的几层角质形成细胞的形态学变化。我们比较了Tzanck涂片检测大棘囊溶解细胞的敏感性，使用切除的顶部组织部分（我们的方法）和病变底部（传统方法）的新鲜囊泡。大棘囊溶解细胞在囊泡顶部组织部分的检测频率是病变底部的2.0倍。与表皮颗粒层或刺状层相对应的囊泡顶部组织部分的圆形细胞比与基底层或刺状层相对应的病变底部的圆形细胞大得多。经VZV感染后，分化的角质形成细胞通过细胞间融合和细胞膜溶解形成多核巨细胞。分化的角质形成细胞通过与HSV - 1或VZV感染的细胞间融合促进多核巨细胞的形成。为了提高灵敏度，应从新鲜囊泡的切除的顶部组织部分制备Tzanck涂片，以检测疱疹感染中的多核巨细胞。
Herpes simplex virus (HSV) and varicella zoster virus (VZV) infections induce the formation of intraepidermal vesicles containing acantholytic cells and multinucleated giant cells in the skin. The Tzanck smear is most commonly used to diagnose cutaneous herpetic infections, but it leads to many false‐positive and ‐negative results. This study aimed at establishing a method detecting much larger multinucleated giant cells using the Tzanck smear because these cells characterize the viral cytopathic effect in skin infections. Morphological changes were analyzed among several layers of keratinocytes with HSV‐ or VZV‐related cutaneous lesions, clinically andin vitro. We compared the sensitivity of the Tzanck smear to detect large acantholytic cells using both the removed roof tissue part (our approach) and the floor of the lesion (conventional approach) of a fresh vesicle. Large acantholytic cells were detected 2.0‐times more frequently in the removed roof tissue part of the vesicle than in the floor of the lesion. Round cells were much larger in the removed roof tissue part of the vesicle corresponding to the granular or prickle layer of the epidermis than in its floor of the lesion corresponding to the basal or prickle layer with the Tzanck smear. Differentiated cultured keratinocytes formed multinucleated giant cells by cell‐to‐cell fusion with resolution of cell membrane with VZV infection. Differentiated keratinocytes promote multinucleated giant cell formation by cell‐to‐cell fusion with HSV‐1 or VZV infection. To increase the sensitivity, the Tzanck smear should be prepared from the removed roof tissue part of a fresh vesicle to detect multinucleated giant cells in herpetic infections.