Abstract:
Atopic dermatitis (AD) is a heterogenous inflammatory skin disorder. Our previous study revealed that basophil infiltration in skin is observed in approximately 60% of AD cases. However, the clinical and histological characteristics of AD associated with basophil infiltration remain unclear. We examined basophil infiltration by immunohistochemical staining of 38 specimens from 34 patients who underwent skin biopsies to diagnose AD from April 2016 to September 2021 at Tokyo Medical and Dental University Hospital. The patients/specimens were divided into two groups, 17 patients/21 specimens associated with little or no basophil infiltration (basophil-low group) and 17 patients/17 specimens associated with marked basophil infiltration (basophil-high group). The clinical characteristics of the patients (age, sex, complications, blood biomarkers, skin symptoms, and treatment) and histological features of the specimens were compared between the groups. Basophil-high patients were significantly younger than basophil-low patients. Blood basophil counts were higher in basophil-high patients than in basophil-low patients. CD4+ T-cell infiltration was more marked in basophil-high specimens than in basophil-low specimens. CD4+ T cells infiltrated into the dermis as well as into the epidermis only in the basophil-high specimens. Thus, basophil-high AD can be characterized by skin lesions associated with abundant helper T-cell infiltration in younger patients.
摘要:
特应性皮炎(AD)是一种异质性炎性皮肤病。我们先前的研究表明,在大约60%的AD病例中观察到皮肤中的嗜碱性粒细胞浸润。然而,与嗜碱性粒细胞浸润相关的AD的临床和组织学特征仍不清楚。我们通过免疫组织化学染色检查了2016年4月至2021年9月在东京医科大学附属医院接受皮肤活检以诊断AD的34例患者的38例标本的嗜碱性粒细胞浸润。患者/标本分为两组,17例患者/21例标本与很少或没有嗜碱性粒细胞浸润相关(嗜碱性粒细胞低组),17例患者/17例标本与明显的嗜碱性粒细胞浸润相关(嗜碱性粒细胞高组)。患者的临床特征(年龄,性别,并发症,血液生物标志物,皮肤症状,和治疗)和组间比较标本的组织学特征。高碱性粒细胞患者明显比低碱性粒细胞患者年轻。高嗜碱性粒细胞患者的血液嗜碱性粒细胞计数高于低嗜碱性粒细胞患者。高嗜碱性粒细胞标本中CD4T细胞浸润比低嗜碱性粒细胞标本中更明显。CD4T细胞仅在高嗜碱性粒细胞标本中渗入真皮和表皮。因此,高嗜碱性粒细胞型AD的特征是在年轻患者中与大量辅助性T细胞浸润相关的皮肤病变。