Mechanisms of itching in mycosis fungoides: grade of itching correlates with eosinophil infiltration and kallikrein 5 expression
Mechanisms of itching in mycosis fungoides: grade of itching correlates with eosinophil infiltration and kallikrein 5 expression
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DOI：
10.1684/ejd.2019.3560
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发表时间：
2019-05-01
影响因子：
2.5
通讯作者：
Shimizu, Tadamichi
中科院分区：
文献类型：
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作者：
Shimizu, Kyoko;Andoh, Tsugunobu;Shimizu, Tadamichi
蕈样肉芽肿（MF）是皮肤T细胞淋巴瘤（CTCL）最常见的变异。瘙痒可能是CTCL患者的主要症状，然而，使用抗组胺药的常规治疗不能缓解MF相关的瘙痒，表明组胺不是主要的致敏原。因此，MF患者瘙痒的潜在机制仍不清楚。目的探讨MF相关性瘙痒的临床和组织病理学特征。材料与方法对MF患者和健康人的皮肤切片进行病理生理学分析和蛋白酶活性评价。将这些结果与瘙痒程度进行比较。结果MF患者中，40%无瘙痒，60%有瘙痒（中度瘙痒：40%;强烈瘙痒：20%）。强瘙痒组中浸润皮肤的嗜酸性粒细胞数量增加，而肥大细胞数量没有增加。在患者的皮肤中，丝氨酸蛋白酶活性和对激肽释放酶5（KLK 5）（一种已知的瘙痒介质）的免疫反应性均相对于瘙痒的等级增加。结论KLK 5和嗜酸性粒细胞浸润可能参与了MF患者瘙痒的发生。
Background Mycosis fungoides (MF) is the most common variant of cutaneous T-cell lymphomas (CTCL). Itching can be a major symptom for patients with CTCL, however, itching associated with MF is not relieved by conventional therapy using anti-histamines, suggesting that histamine is not the main pruritogen. Therefore, the underlying mechanisms of itching in MF patients remain unclear. Objectives To investigate the clinical and histopathological features associated with MF-related itching. Materials and Methods Skin sections from MF patients and healthy subjects were used for pathophysiological analysis and evaluation of protease activity. These results were compared with the degree of itching. Results Of the MF patients, 40% did not report itching and 60% reported itching (moderate itching: 40%; strong itching: 20%). The number of eosinophils, but not mast cells, that infiltrated into skin was increased in the group with strong itching. In the skin of patients, both serine protease activity and immunoreactivity to kallikrein 5 (KLK5), a known itch mediator, increased relative to the grade of itching. Conclusion These results suggest that KLK5 and eosinophil infiltration may be involved in itching in patients with MF.