本文選題：扁平苔蘚 + IL-22��； 參考：《吉林大學》2017年碩士論文

【摘要】：扁平苔蘚是一種臨床上比較常見的累及皮膚黏膜的瘙癢性疾病,典型皮損為紫羅蘭色的扁平的多角形丘疹,表面有蠟樣薄膜,伴有少許鱗屑;典型粘膜表現為Wickham紋。扁平苔蘚病因學機制目前尚未完全明確,但基底細胞液化變性和真皮淺層淋巴細胞帶狀浸潤的病理現象提示細胞介導的免疫反應與該病的發(fā)病機制密切相關。IL-22是一種由Th17和Th22為主的免疫細胞分泌產生的新型CD4+Th細胞因子,主要生物學功能為微生物防御、保護和修復組織損傷及急性期反應,IL-22獨特的免疫介導形式使其在很多炎癥性、自身免疫性、腫瘤性皮膚病中發(fā)揮重要作用。目前對IL-22在扁平苔蘚中的研究較少,因此本實驗通過檢測IL-22在扁平苔蘚皮損中的表達情況,并與正常皮膚相比較,以推測IL-22在扁平苔蘚發(fā)病過程中可能起的作用,為扁平苔蘚的診斷和治療開辟新的思路。目的:探討白介素-22在扁平苔蘚皮損中的表達情況,為深入揭露疾病的發(fā)病機制提供理論基礎,為臨床治療提供新的思路和靶點。方法:實驗組30例(男18例,女12例,年齡19~63歲,平均年齡42.3±8.4歲),均為吉林大學第二醫(yī)院皮膚科經臨床和病理檢查確診的扁平苔蘚患者的病變皮膚;對照組10例(男5例,女5例,年齡22-66歲,平均年齡45.6±7.3歲),均為吉林大學第二醫(yī)院皮膚外科手術切除的正常皮膚。兩組患者年齡和性別相匹配。采用免疫組織化學方法檢測IL-22在扁平苔蘚皮損和正常皮膚組織中的表達情況,并運用統(tǒng)計學軟件進行結果分析。結果:在30例實驗組中,16例為強陽性,8例為陽性,4例為弱陽性,2例為陰性。IL-22主要表達于扁平苔蘚表皮全層的角質形成細胞和真皮淺層浸潤的淋巴細胞胞質中,呈棕黃色顆粒。在10例對照組中,1例為強陽性,2例為陽性,4例為弱陽性,3例為陰性。IL-22主要表達于正常皮膚組織基底層附近的角質形成細胞中,呈淡黃色顆粒。其中IL-22在扁平苔蘚皮損中的表達水平明顯高于在正常皮膚組織中的表達水平,差異具有顯著統(tǒng)計學意義(P0.01)。結論:1、IL-22在大多數扁平苔蘚皮損的表皮全層呈陽性表達,并且IL-22在扁平苔蘚表皮中的表達水平明顯高于正常皮膚組織,提示它可能參與扁平苔蘚的發(fā)病。2、IL-22在大部分扁平苔蘚真皮淺層淋巴細胞浸潤區(qū)呈陽性表達,提示它可能是造成扁平苔蘚炎癥細胞浸潤的原因之一。3、IL-22在大多數正常皮膚組織中呈弱陽性表達,主要定位于表皮的基底層,提示它可能參與角質形成細胞的正常分化。
[Abstract]:Lichen planus is a common pruritus disease involving skin and mucosa. Typical lesions are violet-colored flat polygonal papules with waxy membrane with a few scales and typical mucosal appearance is Wickham's stria. The etiological mechanism of lichen planus is not completely clear. However, the pathological phenomena of liquefaction of basal cells and band infiltration of superficial dermal lymphocytes suggest that cell-mediated immune response is closely related to the pathogenesis of the disease. IL-22 is produced by the secretion of Th17 and Th22 mainly by immune cells. Novel CD4 Th cytokines, The main biological functions are microbial defense, protection and repair of tissue damage and the unique immune-mediated form of IL-22, which play an important role in many inflammatory, autoimmune and tumorous skin diseases. There are few studies on the expression of IL-22 in lichen planus (LP), so the expression of IL-22 in Lichen planus was detected and compared with that in normal skin to speculate the possible role of IL-22 in the pathogenesis of Lichen planus. It provides a new idea for the diagnosis and treatment of lichen planus. Objective: to investigate the expression of interleukin-22 in the lesions of lichen planus (Lichen planus), to provide a theoretical basis for revealing the pathogenesis of the disease, and to provide new ideas and targets for clinical treatment. Methods: 30 cases (male 18, female 12, age 1963 years old, mean age 42.3 鹵8.4 years) in the experimental group were all skin lesions of lichen planus patients confirmed by clinical and pathological examination in the Department of Dermatology, second Hospital of Jilin University, and 10 cases (5 males) in the control group. Five women, aged 22-66 years, with an average age of 45.6 鹵7.3 years, were all normal skin surgically resected by skin surgery in the second Hospital of Jilin University. Age and sex were matched between the two groups. Immunohistochemical method was used to detect the expression of IL-22 in lichen planus lesions and normal skin tissues, and the results were analyzed by statistical software. Results: in the 30 cases of experimental group, 16 cases were strongly positive and 8 cases were positive, 4 cases were weak positive, 2 cases were negative. IL-22 was mainly expressed in keratinocytes of the whole layer of lichen planus epidermis and the cytoplasm of lymphocytes infiltrated in the superficial dermis, showing brown granules. In 10 cases of control group, 1 case was strongly positive, 2 cases were positive, 4 cases were weak positive, 3 cases were negative. IL-22 was mainly expressed in keratinocytes near the basal layer of normal skin tissue. The expression of IL-22 in lichen planus lesions was significantly higher than that in normal skin tissues, and the difference was statistically significant (P 0.01). Conclusion the expression of IL-22 in the epidermis of most lichen planus lesions was positive, and the expression level of IL-22 in the epidermis of lichen planus was significantly higher than that in normal skin tissue. It suggests that it may be involved in the pathogenesis of lichen planus. 2IL-22 is positively expressed in the infiltrating area of most of the epidermis lymphocytes of lichen planus. These results suggest that it may be one of the causes of Lichen planus inflammatory cell infiltration. IL-22 is weakly expressed in most normal skin tissues, mainly located in the basal layer of epidermis, suggesting that IL-22 may be involved in the normal differentiation of keratinocytes.
【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R758.65

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