肉芽肿性酒渣鼻(GR)的发病机制,酒渣鼻的唯一变种,不清楚。探讨GR与非肉芽肿性酒渣鼻(NGR)临床特征的差异。组织病理学改变和基因表达,为研究酒渣鼻的发病机制提供新思路。共纳入30例GR和60例NGR患者。回顾性收集他们的临床和组织病理学信息,并通过多次免疫组织化学染色研究免疫细胞浸润的特征。对来自GR和NGR患者的三对皮肤样本进行RNA测序和转录组分析,分别。然后,免疫组织化学染色证实了与肉芽肿形成潜在相关的候选基因的表达。发现GR患者更容易发生前额酒渣鼻,眼周和口周皮肤(p=0.001,p<0.001,p=0.001),与NGR患者相比,丘疹和脓疱更严重(p=0.032)。对于组织病理学特征,GR组的炎症细胞主要浸润在毛囊周围,NGR组的血管周围。此外,中性粒细胞较丰富(p=0.036),CD4+的表达水平,GR组的CD8+和CD68+细胞高于NGR组(p=0.047,p<0.001,p<0.001)。此外,GR组有明显的胶原增生(p=0.026)。共检测到420个差异表达基因(DEGs),和生物信息学分析表明,DEGs富含中性粒细胞活化,适应性免疫反应和其他生物过程。最后,与中性粒细胞活化和胶原增生相关的候选基因,即,组织蛋白酶S(CTSS),组织蛋白酶Z(CTSZ)和基质金属蛋白酶9(MMP9),证实在GR组中高表达。与NGR相比,GR的临床和组织病理学特征表现出非常不同的模式,其机制可能与中性粒细胞活化和胶原增生有关。
The pathogenesis of
granulomatous rosacea (GR), the only variant of rosacea, is unclear. To investigate the differences between GR and non-
granulomatous rosacea (NGR) in clinical characteristics, histopathological changes and gene expression for the purpose of providing new ideas on the pathogenesis of rosacea. A total of 30 GR and 60 NGR patients were included. Their clinical and histopathological information was collected retrospectively, and the characteristics of immune cell infiltration were investigated by multiple immunohistochemical staining. RNA sequencing and transcriptome analysis were performed on three pairs of skin samples from GR and NGR patients, respectively. Then, the expressions of candidate genes that were potentially associated with granuloma formation were verified by immunohistochemical staining. It was found that GR patients were more prone to the occurrence of rosacea in the forehead, periocular and perioral skin (p = 0.001, p < 0.001, p = 0.001), and presented more severe papules and pustules when compared with NGR patients (p = 0.032). For histopathological features, the inflammatory cells primarily infiltrated around hair follicles in the GR group and around blood vessels in the NGR group. In addition, the neutrophils were richer (p = 0.036) and the expression levels of CD4+ , CD8+ and CD68+ cells were higher (p = 0.047, p < 0.001, p < 0.001) in the GR group than in the NGR group. In addition, the GR group had apparent collagen hyperplasia (p = 0.026). A total of 420 differentially expressed genes (DEGs) were detected, and bioinformatics analysis showed that the DEGs were enriched in neutrophil activation, adaptive immune response and other biological processes. Lastly, the candidate genes related to neutrophil activation and collagen hyperplasia, i.e., Cathepsin S (CTSS), Cathepsin Z (CTSZ) and matrix metalloproteinases 9 (MMP9), were confirmed to be highly expressed in the GR group. The clinical and histopathological features of GR exhibited a very diverse pattern compared with NGR, and the underlying mechanisms may be related to neutrophil activation and collagen hyperplasia.