CAJ | 학술논문

目的：探讨活化抗原CD69和HLA-DR在寻常性银屑病患者外周血CD3+T淋巴细胞和皮损中的表达变化。方法流式细胞仪检测20例寻常性银屑病患者和20例健康对照外周血CD3+T细胞中CD69和HLA-DR的表达，同时采用免疫组化的方法检测15例寻常性银屑病患者和10例健康对照皮损组织中HLA-DR的表达并进行对比。两组统计学分析采用双侧t检验。结果 CD69和HLA-DR在寻常性银屑病患者外周血CD3+T细胞中的表达率分别为（4．70±1．90）％、（8．97±1．79）％，比健康对照组[（1．56±0．95）％、（3．02±1．15）％]明显升高（均P<0．01）。Pearson相关性分析发现，CD3+HLA-DR+细胞百分比与银屑病皮损和严重程度评分指数（PASI）评分呈正相关（r=0．5626，P<0．05）。与健康对照组比较，寻常性银屑病患者皮损真皮中HLA-DR表达升高，但表皮中HLA-DR表达降低（均P<0．05），HLA-DR在健康人主要分布在血管周围，而在寻常性银屑病患者则广泛表达于真皮组织。结论寻常性银屑病患者外周血CD3+T淋巴细胞及皮损中的炎症细胞存在异常活化，外周血CD3+HLA-DR+细胞与疾病严重程度存在相关性。
목적：탐토활화항원CD69화HLA-DR재심상성은설병환자외주혈CD3+T림파세포화피손중적표체변화。방법류식세포의검측20례심상성은설병환자화20례건강대조외주혈CD3+T세포중CD69화HLA-DR적표체，동시채용면역조화적방법검측15례심상성은설병환자화10례건강대조피손조직중HLA-DR적표체병진행대비。량조통계학분석채용쌍측t검험。결과 CD69화HLA-DR재심상성은설병환자외주혈CD3+T세포중적표체솔분별위（4．70±1．90）％、（8．97±1．79）％，비건강대조조[（1．56±0．95）％、（3．02±1．15）％]명현승고（균P<0．01）。Pearson상관성분석발현，CD3+HLA-DR+세포백분비여은설병피손화엄중정도평분지수（PASI）평분정정상관（r=0．5626，P<0．05）。여건강대조조비교，심상성은설병환자피손진피중HLA-DR표체승고，단표피중HLA-DR표체강저（균P<0．05），HLA-DR재건강인주요분포재혈관주위，이재심상성은설병환자칙엄범표체우진피조직。결론심상성은설병환자외주혈CD3+T림파세포급피손중적염증세포존재이상활화，외주혈CD3+HLA-DR+세포여질병엄중정도존재상관성。
Objective To investigate changes in expressions of activation antigens CD69 and HLA-DR in CD3+T lymphocytes in peripheral blood and skin lesions in patients with psoriasis vulgaris. Methods Peripheral blood samples were obtained from 20 patients with psoriasis vulgaris and 20 healthy controls, and skin specimens from the lesions of 15 out of the 20 patients and 10 healthy controls. Flow cytometry was performed to quantify the expressions of CD69 and HLA-DR in peripheral blood CD3+T cells, and an immunohistochemical study to measure the expression of HLA-DR in skin specimens. Statistical analysis was carried out by a two-sample t-test and Pearson correlation analysis with the SPSS 19.0 software. Results Compared with the healthy controls, the patients with psoriasis vulgaris showed increased expression rates of CD69 (4.70%± 1.90%vs. 1.56%± 0.95%, t=6.629, P<0.01)and HLA-DR (8.97%± 1.79% vs. 3.02% ± 1.15%, t= 6.204, P< 0.01)in peripheral blood. Pearson correlation analysis revealed that the percentage of CD3+HLA-DR+cells in peripheral blood was positively correlated with the psoriasis area and severity index (PASI)score (r=0.5626, P<0.05). The expression rate of HLA-DR was significantly higher in the dermis (64.87%± 17.31%vs. 19.80%± 5.69%, t=7.916, P<0.01), but lower in the epidermis(11.80%± 5.55%vs. 27.40%± 8.61%, t=5.479, P<0.01)in the psoriatic specimens compared with the control specimens. Immunohistochemically, HLA-DR was widely expressed in the dermis of psoriatic lesions, but mainly distributed around blood vessels in the control skin. Conclusions There is an aberrant activation of CD3+T cells in peripheral blood and inflammatory cells in skin lesions in patients with psoriasis vulgaris, and the percentage of CD3 +HLA-DR+ cells in peripheral blood is correlated with the severity of psoriasis vulagaris.