Eosinophilic fasciitis induced by a game of drumming probably via type 2 innate immunity
Eosinophilic fasciitis induced by a game of drumming probably via type 2 innate immunity
复制标题
打鼓游戏诱发的嗜酸性筋膜炎可能是通过 2 型先天免疫引起的
DOI：
10.1111/1756-185x.14284
复制
发表时间：
2022
影响因子：
2.5
通讯作者：
Yamanaka Keiichi
中科院分区：
文献类型：
--
作者：
Watanabe Seimi;Kondo Makoto;Ichishi Masako;Hayashi Akinobu;Matsushima Yoshiaki;Hirokawa Yoshifumi;Habe Koji;Yamanaka Keiichi
我们报告一例由剧烈体力活动引发的嗜酸性筋膜炎，在随访期间没有复发。我们确定，白细胞介素-33（IL-33）在剧烈运动后从血管内皮细胞释放，诱导2型先天淋巴细胞（ILC 2）并引起筋膜炎。一位健康的女性在一场击鼓比赛后几个小时出现四肢瘙痒。她的手、膝关节和腿逐渐肿胀，表面静脉沿着有沟迹。白色血细胞和嗜酸性粒细胞计数显著升高。磁共振成像显示双下肢筋膜处有高信号。左下肢组织标本的组织病理学检查结果显示筋膜水肿，伴嗜酸性粒细胞。泼尼松龙治疗结束后，未观察到嗜酸性筋膜炎复发。对筋膜组织进行IL-4、IL-5、IL-33、肿瘤坏死因子-α和干扰素-γ的免疫染色。IL-4和IL-5在肌肉和筋膜水平的淋巴细胞上染色;然而，CD 3和CD 4在这些细胞中未染色，表明这些细胞是ILC 2。肿瘤坏死因子-α和干扰素-γ未染色。筋膜中的血管内皮细胞强烈表达IL-33。在当前病例中，嗜酸性筋膜炎可能与IL-33触发的2型免疫相关。
We report a case of eosinophilic fasciitis triggered by strenuous physical activity, which did not relapse during the follow‐up period. We ascertained that interleukin‐33 (IL‐33) was released from the vascular endothelial cells after intense exercise, inducing type 2 innate lymphocytes (ILC2) and causing fasciitis. A healthy woman experienced itching on both limbs a few hours after a game of drumming. Her hand, knee joints, and legs gradually swelled up with groove signs along the superficial veins. White blood cell and eosinophil counts were significantly elevated. Magnetic resonance imaging revealed a high signal at the fascia on both lower limbs. Histopathological findings of the left lower limb tissue specimen showed edematous fascia with eosinophils. No relapse of eosinophilic fasciitis was observed after finishing treatment with prednisolone. Immunological staining for IL‐4, IL‐5, IL‐33, tumor necrosis factor‐α, and interferon‐γ was performed on the fascial tissue. Both IL‐4 and IL‐5 were stained on the lymphocytes at the muscle and fascia levels; however, CD3 and CD4 were unstained in these cells, suggesting that those cells were ILC2. Tumor necrosis factor‐α and interferon‐γ were unstained. Vascular endothelial cells in the fascia strongly expressed IL‐33. Eosinophilic fasciitis may be associated with type 2 immunity triggered by IL‐33 in the current case.