Autoantibodies to sweat glands detected by different methods in serum and in tissue from patients affected by a new variant of endemic pemphigus foliaceus
Autoantibodies to sweat glands detected by different methods in serum and in tissue from patients affected by a new variant of endemic pemphigus foliaceus
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DOI：
10.1007/s00403-009-0972-4
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发表时间：
2009-10-01
影响因子：
3
通讯作者：
Hashimoto, Takashi
中科院分区：
文献类型：
--
作者：
Abreu-Velez, Ana Maria;Howard, Michael S.;Hashimoto, Takashi
我们对哥伦比亚巴格雷一种新型地方性叶状天疱疮（EPF）患者进行了研究，发现腋窝周围有多形态的临床病变。基于我们的临床发现和之前对这些患者皮肤的组织病理学研究，显示他们的汗腺异常，以及硒化汞和碘的存在，我们决定研究这些患者对汗腺的免疫反应性。我们使用直接和间接免疫荧光（DIF， IIF）检测自身反应性。为了能够区分非特异性免疫沉积和真正的自身免疫反应，并且知道汗腺对脂褐素颗粒的存在有一些内在的自身荧光（在紫外显微镜下自然荧光），以及分泌IgA的存在，我们同时使用了免疫组织化学（IHC）。我们测试了10名El Bagre-EPF患者，10名来自流行地区的健康对照者和10名来自美国的健康对照者。我们能够通过DIF、IIF和IHC观察到8/10 El Bagre-EPF患者对汗腺的特异性自身反应性。此外，当使用针对CD3、CD68和CD20的抗人单克隆抗体时，我们证实了在原位和汗腺周围存在几种特异性免疫反应。没有健康对照病例出现阳性结果。在一些慢性病例中，发现汗腺和其他皮肤附件减少，有时完全没有。除此之外，还观察到硬化皮样改变或早期硬化皮样改变，有时会扩展到脂肪组织，表现为膜性脂肪营养不良。对汗腺周围神经血管成分的自身反应性也被观察到。我们的数据首次证明，El Bagre-EPF患者的汗腺存在免疫反应性，似乎破坏了这些结构中的一些。
Examining the patients with a new variant of endemic pemphigus foliaceus (EPF) in El Bagre, Colombia, (El Bagre-EPF), we noted several polymorphic clinical lesions around their axillary areas. Based on our clinical findings and on previous histopathological studies on the skin of these patients that showed abnormalities in their sweat glands, and the presence of mercuric selenides and iodines by autometallography assay, we decided to investigate immunoreactivity to the sweat glands in these patients. We tested for autoreactivity utilizing direct and indirect immunofluorescence (DIF, IIF). To be able to distinguish between non-specific immune deposits and real autoimmune response, and knowing that sweat glands have some intrinsic autofluorescence for the presence of lipofuscin granules (that naturally fluoresce under the UV light microscope), as well as by the presence of secretory IgA, we used simultaneously immunohistochemistry (IHC). We tested ten El Bagre-EPF patients, ten healthy controls from the endemic area and ten healthy controls from the United States. We were able to visualize a specific autoreactivity to sweat glands in 8/10 cases of El Bagre-EPF by DIF, IIF and by IHC. In addition when using anti-human monoclonal antibodies to CD3, CD68, and CD20, we confirmed the presence of several specific immune responses in situ, an around the sweat glands. No healthy control cases yielded positive findings. In some chronic cases, decrease and sometimes a complete absence of sweat glands and other skin appendices was found. In addition to this, sclerodermoid changes or early sclerodermatous changes sometimes extending into the adipose tissue as a membranous lipodystrophy were observed. Autoreactivity to the neurovascular components around the sweat glands were also observed. Our data demonstrate for the first time that there is immunoreactivity toward sweat glands in El Bagre-EPF patients that seems to destroy some of these structures.