多形性日光疹皮损中板层小体分布、神经酰胺酶表达与皮肤屏障功能

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1、多形性日光疹皮损中板层小体分布、神经酰胺酶表达与皮肤屏障功能涂颖李娜顾华起珏何黎[摘要]目的探讨多形性日光疹(PLE)表皮中板层小体的分布、神经酰胺酶的表达与皮肤屏障受损的相关性。方法选取PLE患者47例及正常人对照40例，通过电镜观察两组皮损处颗粒层、棘层板层小体的数量及分布情况，运用免疫组化测定皮损处神经酰胺酶的表达，采用无创性皮肤测试仪测量皮损处经皮水分丢失(TEWL)、角质层含水量及皮脂含量。结果透射电镜结果显示：与对照组相比，PLE患者颗粒层、棘层板层小体数量明显少于正常人对照组，分布

2、较正常人对照组紊乱。免疫组化结果显示：PLE患者皮损处神经酰胺酶表达20例阳性、21例弱阳性、6例阴性；正常人对照组中36例阳性、4例弱阳性，差异有统计学意义(P＜0.01)；皮损处TEWL(34.2191±12.70)较正常人对照组(16.8350±6.50)高，角质层含水量(22.7319±8.71)较正常人对照组(29.4250±5.08)低，差异有统计学意义(P＜0.01)；皮脂含量两者之间差异无统计学意义。结论PLE患者存在神经酰胺合成障碍，可能是皮肤屏障受损的原因之一。多形性日光疹；

3、皮肤屏障；板层小体；半乳糖神经酰胺酶Lamellarbodydistribution,ceramidaseexpressionandskinbarrierfunctioninlesionsofpolymorphouslighteruptionTUYingLINaGUHuaQIJueHELiDepartmentofDermatology,FirstAffiliatedHospitalofKunmingMedicalUniversity,YunnanProvincialInstituteofDerm

4、atologyandVenereology,Kunming650032,China[Abstract]ObjectiveToinvestigatethecorrelationofepidermaldistributionoflamellarbodiesandexpressionofceramidasewithskinbarrierdysfunctioninpolymorphouslighteruption.MethodsForty-sevenpatientswithpolymorphouslig

5、hteruptionand40healthyvolunteerswererecruitedintothisstudy.Noninvasiveinstrumentswereusedtomeasureskinsebumcontent,transepidermalwaterloss(TEWL)andwatercontentinstratumcorneuminallofthesubjects.Then,tissuespecimenswereobtainedfromthelesionsatsunexpos

6、edsitesinthepatientsandnormalskinofthehealthyvolunteers.Theultrastructureanddistributionoflamellarbodieswereobservedwithtransmissionelectronmicroscopyinfivelesionandcontrolspecimens.Immunohistochemistrywasperformedtodetecttheexpressionofceramidaseint

7、hetissuespecimens.ResultsComparedwiththenormalskinfromhealthyvolunteers,thelesionsfrompatientsshoweddecreasednumberoflamellarbodiesinthegranularlayerandprickcelllayerwithadisorganizedarrangement.Ceramidasewaspositivelyexpressedin20lesionspecimensand3

8、6normalcontrolspecimens,weaklyexpressedin21lesionspecimensand4normalcontrolspecimens,andnegativein6lesionspecimens;therewasasignificantdifferenceintheexpressionofceramidasebetweenthelesionspecimensandnormalcontrolspecimens(P＜0.01).Thelesionsalsoshowe