Immunohistochemical study of disease-specific immune reaction in inflammatory bowel disease.

应用免疫组织化学和流式细胞术，从局部淋巴细胞扩张的角度对溃疡性结肠炎进行分析。溃疡性结肠炎以弥漫性分布的Ki-67+小圆形细胞为特征，尤其是在溃疡基底部(CD19+和CD20-)，也有相当数量的CD138+。CD19免疫电子显微镜显示胞浆内有丰富的粗面内质网。这表明它们属于未成熟的浆系细胞。相比之下，克罗恩病的浆细胞CD19阴性，Ki-67标记较少，表现为成熟表型。流式细胞术显示CD19+和CD20-细胞在溃疡性结肠炎中出现，但在克罗恩病中未见。CD19+浆细胞Ki-67标记指数与溃疡性结肠炎的临床活动性呈正相关。CD19+浆细胞中Ki-67的高标记是对MED…耐药的活动期溃疡性结肠炎的特异性接下来，我们用免疫组织化学方法研究了Th1反应和SLC、ELC在克罗恩病发病机制中的作用。在肠道样本中几乎检测不到ELC。淋巴滤泡、淋巴聚集小静脉和淋巴管内可见散在分布的SLC。在肠系膜淋巴结(MLN)中，SLC在高内皮微静脉(HEV)、淋巴管和间质树突状细胞(DC)中高表达，主要分布在T细胞区。ELC在成熟DC中高表达。在克罗恩病患者中，T细胞区的重要组成部分SLC阳性的HEV和ELC阳性的成熟DC显著增多。克罗恩病MLN中SLC、ELC和CCR7mRNA的表达显著高于溃疡性结肠炎。克罗恩病MLN中SLC和ELC表达增加，主要分布在HEV、成熟树突状细胞和淋巴管，导致T细胞增殖。CCR7mRNA在T细胞区表达增加。SLC阳性HEV/淋巴管、ELC阳性成熟树突状细胞和增生性T细胞区CCR7阳性T细胞的相互作用促进了Th1免疫应答。在克罗恩病中，记忆T细胞和成熟树突状细胞可能较少

We analyzed ulcerative colitis from the standpoint of lymphocytic expansion in the loco by immunohistochem- istry and flow cytometry. Ulcerative colitis was character- ized by a diffuse distribution of Ki-67+ small round cells particularly in the ulcer base (that were CD19+ and CD20-), with a significant number of them also CD138+. Immuno- electron microscopy for CD19 revealed an abundance of rough endoplasmic reticulum in the cytoplasm. These in- dicated that they are of immature plasma lineage cells. By contrast, plasma cells in Crohn's disease were negative for CD19, and the labeling for Ki-67 was infrequent, showing mature phenotype. Flow cytometry revealed an occurrence of CD19+ and CD20- cells in ulcerative colitis but not in Crohn's disease. The labeling index of Ki-67 among CD19+ plasma cells was positively correlated with the clinical activity of ulcerative colitis. High labeling of Ki-67 in CD19+ plasma cells is specific for active ulcerative colitis that was resistant to med … More ical treatment by corticosteroids.Next, We investigated he Th1 response and SLC and ELC in Crohn's disease pathogenesis immunohistochemicaly. ELC was almost undetectable in intestinal samples. SLC was found sporadically in lymphoid follicles, lymphoid aggregate venules, and lymphatic vessels. In mesenteric lymph nodes (MLNs), SLC was highly expressed in high endothelial venules (HEVs), lymphatic vessels, and stromal Dendritic cells (DCs), predominantly in T cell areas. ELC was highly expressed in mature DCs. There were significantly more SLC positive HEVs and ELC positive mature DCs, important components of T cell areas, in Crohn's disease. SLC, ELC, and CCR7 mRNA was significantly higher in Crohn's disease MLNs compared with Ulcerative colitis. Crohn's disease MLNs had increased expression of SLC and ELC, mainly in HEVs, mature DCs, and lymphatic vessels, inducing T cell hyperplasia. CCR7 mRNA was increased in T cell areas. The dominant Th1 immune response is facilitated by interaction of SLC positive HEVs/lymphatic vessels, ELC positive mature DCs, and CCR7 positive T cells in hyperplastic T cell areas. In Crohn's disease, memory T cells and mature DCs may home to MLN Less