Characterization of inflammatory cell infiltrate of scleroderma skin: B cells and skin score progression.
Characterization of inflammatory cell infiltrate of scleroderma skin: B cells and skin score progression.
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DOI：
10.1186/s13075-018-1569-0
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发表时间：
2018-04-18
影响因子：
4.9
通讯作者：
Ferraccioli G
中科院分区：
文献类型：
--
作者：
Bosello S;Angelucci C;Lama G;Alivernini S;Proietti G;Tolusso B;Sica G;Gremese E;Ferraccioli G
本研究的目的是调查的频率和分布的炎症细胞浸润在两组皮肤活检来自临床影响和未受影响的皮肤系统性硬化症（SSc）患者，并测试细胞浸润和皮肤受累的进展之间的相关性。对28例SSc患者的临床受累和未受累皮肤进行免疫化学评估，以鉴定CD 68、CD 3、CD 20和CD 138阳性（+）细胞。随访6个月，根据病程、临床特征和皮肤受累进展分析浸润特征。在所有的SSc皮肤标本中，细胞浸润被发现在血管周围的位置，主要是在中间和更深的部分的真皮。所有分析的活组织检查均显示CD 3+和CD 68+细胞浸润，临床受累皮肤中CD 3+和CD 68+细胞的平均数量较高（CD 3+，71.7 ± 34.6和CD 68+，26.3 ± 8.4）（分别为CD 3+，45.7 ± 36.0和CD 68+，13.6 ± 6.1）（两个比较的p < 0.001）。在17例（60.7%）患者中发现了CD 20+细胞，在这些患者中，临床受累皮肤中的CD 20+细胞平均数（4.7 ± 5.9）高于未受累皮肤（1.9 ± 2.9）（p = 0.04）。早期SSc患者的CD 20+细胞数量多于长期存在疾病的患者。CD 138+细胞在100%的临床受累皮肤活检和89.3%的未受累皮肤活检中被发现。临床受累皮肤的CD 138+细胞平均数（3.6 ± 2.3）高于临床未受累皮肤（1.9 ± 1.7）（p < 0.001）。随访6个月后，7例患者的皮肤评分恶化超过20%;所有患者在临床受累皮肤活检时均出现CD 20+皮肤浸润。我们的研究结果证实单核细胞存在于所有SSc患者的皮肤中，强调了炎症细胞浸润在SSc皮肤受累中的作用。皮肤中的B细胞似乎是早期弥漫性皮肤病患者的特征，并与皮肤进展相关。本文的在线版本（10.1186/s13075-018-1569-0）包含补充材料，可供授权用户使用。
The purpose of this study was to investigate the frequency and the distribution of inflammatory cell infiltrate in two sets of cutaneous biopsies derived from clinically affected and unaffected skin in patients with systemic sclerosis (SSc) and to test correlation between the cell infiltrate and the progression of skin involvement. Skin was immunohistochemically assessed to identify CD68, CD3, CD20 and CD138-positive (+) cells in clinically affected and unaffected skin in 28 patients with SSc. Patients were followed for 6 months and the characteristics of the infiltrate were analyzed according to disease duration, clinical features and skin involvement progression. In all SSc cutaneous specimens, cellular infiltrates were found in a perivascular location predominantly in the mid and deeper portions of the dermis. All the analyzed biopsies showed a CD3+ and CD68+ cell infiltrate and the mean number of CD3+ and of CD68+ cells was higher in clinically involved skin (CD3+, 71.7 ± 34.6 and CD68+, 26.3 ± 8.4, respectively) than in clinically uninvolved skin (CD3+, 45.7 ± 36.0 and CD68+, 13.6 ± 6.1, respectively) (p < 0.001 for both comparisons). CD20+ cells were found in 17 (60.7%) patients and in these patients the mean number of CD20+ cells was higher in clinically involved (4.7 ± 5.9) than in uninvolved skin (1.9 ± 2.9), (p = 0.04). There was a greater number of CD20+ cells in patients with early SSc compared with patients with long-standing disease. CD138+ cells were found in 100% of biopsies of clinically involved skin and in 89.3% of biopsies of uninvolved skin. The mean number of CD138+ cells was higher in clinically involved skin (3.6 ± 2.3) than in clinically uninvolved skin (1.9 ± 1.7), (p < 0.001). Seven patients experienced more than 20% worsening in the skin score after 6 months of follow up; all of them had a CD20+ skin infiltrate on biopsy of clinically involved skin. Our results confirm that mononuclear cells are present in the skin of all patients with SSc, underlining the role of inflammatory cell infiltrates in skin involvement in SSc. B cells in the skin seem to characterize patients with early diffuse skin disease and to correlate with skin progression. The online version of this article (10.1186/s13075-018-1569-0) contains supplementary material, which is available to authorized users.
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