Involvement of T lymphocyte microchimerism in molecular mechanism of the induction and development of oral lichen planus

目的：母胎微嵌合体引起的移植物抗宿主反应（GVHR）可能是引起该疾病的主要原因。因此，我们报道了母胎微嵌合体和干燥综合征之间的可能关系，与cGVHD有一些相似之处。在这项研究中，我们调查了女性口腔扁平苔藓（OLP）患者中是否存在具有男性DNA的细胞，因为在cGVHD患者中经常观察到OLP样病变。我们研究了27例双侧颊粘膜OLP的女性患者。分别从13例和所有27例患者的外周病变中提取DNA。然后通过实时聚合酶链反应（PCR）和Y染色体特异性序列检查男性DNA的存在。采用荧光原位杂交（FISH）和免疫组化双重染色法检测活检标本中Y染色体细胞的存在和分布. 27例活检标本中有6例通过实时PCR检测Y染色体特异性序列呈阳性。活检标本Y染色体特异性序列阳性的6例患者至少经历了以下情况之一：男婴分娩、流产和输血。FISH和免疫组化双重染色显示，活检组织中存在Y染色体T细胞.如果获得研究的知情同意，则计划检查HLA分型，并通过患者本人和儿童进行OLP患者的HLA基因分析，而不询问儿童的性别。尽管人们认为SS的机制和疾病的OLP表现不仅可以通过靶抗原的鉴定来解释，并开发有效的治疗方法。

Objective : It is possibly induced by graft versus host reaction (GVHR) following maternal-fetal microchimerism. We thus have reported a possible relation between maternal-fetal microchimerism and Sjogren's syndrome with some similarities to cGVHD. In this research, we investigated whether cells with male DNA exist in female patients with oral lichen planus (OLP), as OLP-like lesions were frequently observed in the patients with cGVHD.1. Twenty-seven female patients with OLP of the bilateral buccal mucosa referred to our clinic were studied. Peripthe lesions were obtained from 13 and all of the 27 patients respectively, and the DNA was extracted. The presence of male DNA was then examined by real-time polymerase chain reaction (PCR) with Y chromosome-specific sequences. The presence and distribution of cells containing the Y chromosome were examined in the biopsy specimens by double staining of fluorescence in situ hybridization (FISH) and immunohistochemical staining.2. Six of 27 biopsy specimens tested positive by real-time PCR for the Y chromosome-specific sequence. The 6 patients whose biopsy specimens were positive for the Y chromosome-specific sequence experienced at least one of the followings: parturition of male child, abortion, and blood transfusion. Furthermore, double staining of FISH and immunohistochemical staining revealed that T cells with the Y chromosome are present in the biopsy specimens.3. If an informed consent was obtained for the research, it was scheduled to be examined HLA typings, and analyzing OLP patient's HLA gene without asking child's sex by doing the patient himself and children.Finally, it did not arrive at the treatment method this time though it was thought that the mechanism of SS and the OLP appearance of disease was able not to be only interpretable with the identification of the target antigen but also to develop an effective treatment method.