B淋巴细胞及白细胞介素-12在OLP中的表达
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摘要
口腔扁平苔藓(oral lichen planus, OLP),是口腔黏膜病中最常见的疾病之一,部分病损可发生恶变,世界卫生组织(WHO)将其列为可能的癌前状态。OLP的病因至今尚不十分清楚,目前认为是一种T细胞介导的免疫反应,其病程慢性迁延,治疗已成为临床上一个相当棘手的问题,目前还没有治愈OLP的方法。其典型病理特征为上皮不全角化,基底层液化变性,固有层密集的淋巴细胞浸润带。OLP淋巴细胞浸润带中虽以T细胞为主,但也有少量的B淋巴细胞,约6%。CD20是B淋巴细胞特有的表面标记,它出现于前B淋巴细胞,B淋巴细胞激活分化将导致CD20的高表达,B淋巴细胞分化至成熟的浆细胞时,CD20表达消失。单核细胞、静息或活化的T细胞、裸细胞及非淋巴细胞均不表达CD20分子。IL-12是一种p35与p40结合成的异二聚体分子,在B淋巴细胞、单核细胞、角质细胞以及DC中都有表达活性,其趋化作用主要由p40来完成。IL-12在Thl细胞介导的免疫反应和炎症性疾病中发挥着重要作用。
     目的:
     本实验通过免疫组化技术及荧光实时定量PCR技术检测正常口腔黏膜与OLP中B淋巴细胞及IL-12的表达情况,以观察B淋巴细胞及IL-12在两种不同组织中的变化规律,探讨其在口腔扁平苔藓发生过程中的作用及意义,为临床上治疗口腔扁平苔藓提供新的思路。
     方法:
     1.收集临床及病理确诊的口腔正常黏膜5例、OLP标本20例,将每个标本的连续切片分别进行HE染色、CD20及IL-12p40免疫组化分析和阴性对照,根据免疫组化结果从蛋白水平观察CD20、IL-12p40在不同组织中的表达情况。
     2.收集正常口腔粘膜组织和临床及病理确诊的OLP各6例,应用PCR技术检测标本中IL-12的表达,验证引物设计合成物无误后,进行荧光实时定量PCR,检测IL-12p40 mRNA在两组中的表达情况。
     结果:
     1.CD20免疫组化结果显示:在正常口腔黏膜中,CD20呈阴性表达。在OLP组织中,CD20在固有层淋巴细胞浸润带中呈阳性表达,且远离基底膜侧。
     2.IL-12p40免疫组化结果显示:在正常口腔粘膜中,IL-12p40呈阳性表达,主要位于棘层及颗粒层细胞以及结缔组织中,其染色略浅。在OLP组织中,IL-12p40呈强阳性表达,其表达范围与正常口腔黏膜中的相似,但其染色较正常口腔黏膜染色要深。
     3.IL-12p40荧光实时定量PCR结果显示:与正常口腔粘膜上皮及结缔组织相比,口腔扁平苔癣上皮及结缔组织中IL-12p40 mRNA的表达量增多,差异有统计学意义(P<0.05)。
     结论:
     CD20在正常口腔粘膜组没有表达,而在OLP组织有表达。IL-12p40 mRNA及蛋白在正常口腔粘膜组的上皮细胞和结缔组织中的表达分别低于其在OLP组织中的表达。提示B淋巴细胞在口腔扁平苔癣的发生发展过程中可能发挥一定的作用——不仅可能与基底膜区IgG、IgM:冗积有关,还可能通过分泌IL-12来促进Thl细胞分化进而参与细胞免疫,为临床上预防及治疗OLP提供新的思路。
The prevalence of oral lichen planus (OLP) ranks second in oral mucosal diseases. Partial cases can transform from OLP into cancer. Accordingly, the World Health Organization(WHO) presume this disease a possible precancer. The etiology and pathogenesis are still obscure. There are extensive data to suggest that OLP is a T cell-mediated immune damage. Much effort has been spent on OLP therapy, but the outcome is still far from satisfaction. Histopathologic examination typically shows orthokeratotic hyperkeratosis, basal cell degeneration, and a dense well-defined infiltrate of lymphocytes in the superficial dermis. In OLP, there is a few B lymphocytes in the lymphocyte infiltration. CD20 is the surface marker of B cell especially. IL-12 is excreted by B cell, mononuclear cell, keratinocyte and DC. IL-12 play a unique role in promoting type 1 T helper cell responses and, thereby, cell-mediated immunity. IL-12 has been shown to exert striking therapeutic effects in a variety of infectious diseases.
     Objective:
     To detect the different expression of B cell, IL-12 in the tissue of normal oral mucosa and OLP at the level of protein by Immunohistochemistry and real time PCR respectively. And it is to be discussed about the function and mechanism involved with B cell and IL-12 in OLP. Different treatment means may be attempted.
     Methods:
     1. The study group consisted of 25 cases, included 20 cases of OLP and 5 cases with normal oral mucosa. These specimens were all defined by clinical and pathological diagnoses. Every specimen would be seriate cut for HE staining, Immunohistochemical staining of CD20 and IL-12p40, negative contrast,respectively. We studied the expression of CD20 and IL-12 in different tissues according to the results at the levels of protein by IH.
     2. OLP (n=6) and normal control (n=6) tissues were defined clinically and pathologically. To detect the expression of IL-12 using PCR technique and real-time PCR.
     3. To observe the distribution of CD20+B lymphocyte and IL-12 in OLP and normal oral tissue. To analyze the data of IL-12p40 mRNA using statistically system.
     Results:
     1. IH results of CD20:In normal mucosa, CD20 was negative.In OLP tissue, CD20 was positive in the lymphocytes infiltration.
     2. IH results of IL-12p40:In normal mucosa, IL-12p40 was positive in spinous layer cells, granulosa layer cells and connective tissues. In OLP, IL-12p40 had similar expression with normal mucosa in epithelium but with a stronger staining.
     3. Compared to normal oral mucosa, the expression of IL-12p40 mRNA is higher in OLP. Values of P<0.05 were considered statistically significant.
     Conclusion:
     CD20 in the tissue of OLP showed a strong expression, while none in the normal oral mucosa. IL-12p40 mRNA in the tissue of OLP shouwed a stronger expression than that in the tissue of normal oral mucosa. CD20+B cell may play a unique role in OLP development and progression by excreting IL-12.
引文
1.林文棠,朱平.使用临床免疫学.西安:第四军医大学出版社,2003:468,
    2. CONL EYJ J, NOVACK A J. The surgical treatment of malignant tumors of the ear and temporal bone. Part I. AMA Arch Otolaryngol,1960,71:635-652.
    3. Salem G. Oral lichen planus among 4277 patients from Gizan, Sandi Arabia. Commanity Dent Oral Epidenmiol,1989,17(6):322-324.
    4. Sigurgeirsson B, Lindelof B. Lichen planus and malignancy:an epidemiolog-ic study of 2710 patients and review of the literature. Areh Dermato 1,1991, 127(11):1684-1688.
    5. Scully C, Beyh M, Ferreiro MC, et al. Update on oral lichen planus: etiopathogenesis and management. Crit Rev Oral Biol Med,1998,9(1):86-122.
    6. Kramer IR, Lucas RB, Pindborg JJ, et al. Definition of leukoplakia and relate lesions:an aid to studies on oral precancer. Oral Surg,1978,46(4):518-539.
    7.李秉琦主编.口腔粘膜病学,第二版.北京:人民卫生出版社,2003.
    8. Molaoglu N. Oral lichen Planus. British Journal of oral Maxilofacial surgery,2000, 38(4):370-377.
    9. McCartan BE, McCreary CE. What is the rationale for treating oral lichen planus? Oral Dis,1999,5(3):181-182.
    10. McCreary CE, McCartan BE. Clinical management of oral lichen planus. Br J Oral Maxillofac Surg,1999,37(5):338-343.
    11. CONL EYJ J, NOVACK A J. The surgical treatment of malignant tumors of the ear and temporal bone. Part Ⅰ. AMA Arch Otolaryngol,1960,71:635-652.
    12.沈苏南,徐智,钱晓萍,等.CD40L对B淋巴细胞表面分子及分泌IL-12的影响[J].南京大学学报(自然科学),2007,43(5):472-477.
    13. Krammer PH. CD95's deadly mission in the immune system. Nature,2000, 407(6805):789-795.
    14. Allen CD, Okada T, Cyster JG. Germinal-center organization and cellular dynamics. Immunity,2007,27(2):190-202.
    15. Kim JR, Lim HW, Kang SG, et al. Human CD57+ germinal center-T cells are the major helpers for GC-B cells and induce class switch recombination. BMC Immunol,20056(1):3-14.
    16. Van Eijk M, Defrance T, Hennino A, et al. Death-receptor contribution to the germinal-center reaction. Trends Immunol,2001,22(12):677-682.
    17. Kobayashi m, Trippcs, Unanue ER. Identification and purification of natural killer cell stimulatory factor (NKSF), a cytokine with multiple biologic effect on human lymphocytes. J Exp Med,1989,170:827.
    18. Wolf SF, Temple PA, Kobayashi M, et al. Cloning of cDNA for natural killer cell stimulatory factor, a heterodimeric cytokine with multiple biologic effects on T and natural killer cells. J Immunol,1991; 146:3074-3081.
    19. Hilkens gM, Snijders A, Snijdewint FG. Modulation of T-cell cytokine secretion by acccessory cell-derived product. Eur Respir J SuppI,1996; 22:90-94.
    20. Biron cA, Gazzinellei RT. Effects of IL-12 on immune responses to microb ial infections:a key mediator in regulating disease outcome. Curr Opin Im-munol,1995; 7:485-496.
    21. Germann t, Rude E. Interleukin-12. Int Arch Allergy Immunol,1995; 108: 103-112.
    22. Gearing dP, Zitvogel L, Tahara H. Homology of the p40 subunit of natural killer cell stimulatory factor (NKSF) with the extracellular domain of the interleukin-6 receptor. Cell,1991; 66:9-10.
    23.Babik JM, Adams E, Tone Y, et al. Expression of murine IL-12 is regulated by translational control of the p35 subunit. J Immunol,1999,162:4069-4078.
    24. Murphy TL, Cleveland MG, Kulesza P, et al. Regulation of interleukin 12 p40 expression through an NF-kappa B half-site. Mol Cell Biol,1995; 15:5258-5267.
    25. A D'Andrea, Rengaraju M, Valiante NM, et al. Production of natural killer cell stimulatory factor (interleukin 12) by peripheral blood mononuclear cells. J Exp Med,1992; 176:1387-1396.
    26. Cassatella MA, Meda L, Gasperini S, et al. Interleukin-12 production by human polymorphonuclear leukocytes. Eur J Immunol,1995; 25:1-5.
    27. Hayes MP, Wang J, and Norcross MA. Regulation of interleukin-12 expression in human monocytes:selective priming by interferon-gamma of lipopolysaccharide-inducible p35 and p40 genes. Blood,1995; 86:646-650.
    28. Biron CA, Orange JS. IL12 in acute viral infectious disease. Res Immunol, 1995; 145(7-8):590-600.
    29. Skeiky YA, Guderian JA, Benson DR, et al. A recombinant Leishmania antigen that stimulates human peripheral blood mononuclear cells to express a Thl-type cytokine profile and to produce interleukin 12. J Exp Med,1995; 181:1527-1537.
    30. Ma X, Chow JM, Gri G, et al. The interleukin 12 p40 gene promoter is primed by interferon gamma in monocytic cells. J Exp Med,1996; 183:147-157
    31. Stuber E, Strober W, and M Neurath. Blocking the CD40L-CD40 interaction in vivo specifically prevents the priming of T helper 1 cells through the inhibition of interleukin 12 secretion. J Exp Med,1996; 183:693-698.
    32. Kraan VDP, T.C.T.M., Boeije, et al. Prostaglandin-E2 is a potent inhibitor of human interleukin 12 production. J Exp Med,1995; 181:775-779.
    33. Rothe H, Hartmann B, Geerlings P, et al. Interleukin-12 gene expression of macrophages is regulated by nitric oxide.Biochem Biophys Res Commun, 1996; 224:159-163.
    34. Elenkov IJ, Webster E, Papanicolaou DA, et al. Histamine potently suppres ses human IL-12 and stimulates IL-10 production via H2 receptors.J Immu-nol,1998; 161(5):2586-93.
    35. Kincy-Cain, T, and Bost KL. Substance P-induced IL-12 production by murine macrophages. J Immunol,1997; 158:2334-2339.
    36. U.Gubler, Szabo, S.J., et al. Regulation of the interleukin (IL)-12Rβ2 sub-unit expression in developing T helper 1(Thl) and Th2 cells. J Exp Med,1 997; 185:817.
    37. Rogge L, Sinigaglia F, D'Ambrosil D, et al. Regulation of The IL-12/IL-12R Axis: a Critical Step in T-Helper Cell Differentiation and Effector Function. Immunol Reviews,1999; 170:65-72.
    38. David H.Presky, Lars Rogge, Luisella Barberis-Maino, et al. Selective Expression of an Interleukin-12 Receptor Component by Human T Helper 1 Cells. J Exp Med, 1997; 185:817.
    39. Betin VM, Gillespie KM, Szeto CC, et al. Role of beta 1 and beta2 subunits of the interleukin-12 receptor in determining T helper 1/T helper 2 responses in vivo in the rat. Immunology,2000; 99:109.
    40. Yu DS, Lee CF, Hsieh DS, et al. Antitumor effects of recombinant BCG and interleukin-12 DNA vaccines on xenografted mutine bladder cancer. Ur ology,2004,63(3):596-601.
    41. Li S, Zhang X, Xia X. Regression of tumor growth and induction of long-term antitumor memory by interleukin-12 electro-gene therapy. Natl Cancer Inst,2002, 94(10):762-768.
    42. Hilkens gM, Snijders A, Snijdewint FG. Modulation of T-cell cytokine secretion by acccessory cell-derived product. Eur Respir J SuppI,1996; 22:90-94.
    43. Kobayashi M, Fitz L, Ryan M, et al. Identification and purification of natural killer cell stimulatory factor (NKSF), a cytokine with multiple biologic effects on human lymphocytes. J Exp Med,1989; 170:827-845.
    44. Lieberman M et al. J Surg Res,1991; 50:410-416.
    45. Clerici M et al. Restoration of HIV-specific cell-mediated immune responses by interleukin-12 in vitro.Science,1993; 262:1721-1724.
    46. Bacon CM, Mc Vicar DW, Ortaldo JR, et al. Interleukin 12 (IL-12) induces tyrosine phosphorylation of JAK2 and TYK2:differential use of Janus family tyrosine kinases by IL-2 and IL-12. J Exp Med,1995; 181:399.
    47. Osamu Miura, Koh Yamamoto, Fumi Shibata, et al. Physical Interaction between Interleukin-12 Receptor β2 Subunit Jak2 Tyrosine Kinase:Jak2 associates with Cytoplasmic Membrane-Proximal Region of Interleukin-12 Receptorβ2 via Amino-Terminus. Biochem Biophys Res Common,1999; 257:400.
    48. Lamont aG, Adorini L. IL-12:a key cytokine in immune regulation. Immune Today,1996; 17:214-217.
    49. Zhu R, Diem S, Araujo LM, et al. The pro-Thl cytokine IL-12 enhances IL-4 production by invariant NKT cells:relevance for T cell-mediated hepatitis. J Immunol,2007,178(9):5435-5442.
    50. Chehimi j, Trinchieri G. Interleukin-12:a bridge between innate resistance and adaptive immunity with a role on infection and acquired immunodeficiency. J Clin Immunol,1994; 14:149-161.
    51. Jacobson n, Martinotti A, Stoppacciaro A. Interleukin-12 signaling in T helper type1(Thl) cells involves tyrosine phosphorylation of signal transducer and acxtivator of transcription (Stat 3) and Stat 4. J Exp Med,1995;81:1755.
    52. Kobayashi m, Trippcs, Unanue ER. Identification and purification of natural killer cell stimulatory factor (NKSF), a cytokine with multiple biologic effect on human lymphocytes. J Exp Med,1989,170:827.
    53. Comez jE, Pinon JM, Borhomm A. Does human toxoplasmosis involve an imbalance in T1/T2 cytokines. Med Hypotheses,1997;48:161-169.
    54. Foli a, Barnea A, Zivogel L. Effects of the Thl and Th2 stimulatory cytokines interleukin-12 and interleukin-4 on human immunodeficiency virus replication. blood,1995;85:2114-2123.
    55. Keane-Myers A, Wysocka M, Trinchieri G, et al. Resistance to antigen-induced airway hyperresponsiveness requires endogenous production of IL-12. J Immunol, 1998;161:919-926.
    56. Kips JC, Brusselle GJ, Joos GF, et al. Interleukin-12 inhibits antigen-induced airway hyperresponsiveness in mice. Am J Respir Crit Care Med, 1996;153:535-539.
    57. Boushey HA, Fahy JV. Targeting cytokines in asthma therapy:round one [editorial]. Lancet,2000;356:2114-2116.
    58. Hogan SP, Foster PS, Tan X, et al. Mucosal IL-12 gene delivery inhibits a llergic airways disease and restores local antiviral immunity. Eur J Immunol, 1998;28:413-423.
    59. Vingerhoets J, Michielsen P, Vanham Q et al. HBV-specific lymphoproliferative and cytokine response in patients with chronic hepatitis B. J Hepatol, 1998,28(1):8-16.
    60. Rigopoulou El, Suri D, Chokshi S, et al. Lamivudine plus interleukin-12 combination therapy in chronic hepatitis B:antiviral and immunological activity. Hepatology,2005,42(5):1028-1036.
    61. O'Brien CB, Moonka DK, Henzel BS, et al. A pilot trial of recombinant interleukin-12 in patients with chronic hepatitis C who previously failed treatment with interferon-alpha. Am J Gastroenterol,2001,96(8):2473-2479.
    62. Komita H, Homma S, Saotome H, et al. Interferon-gamma produced by interleukin-12 activated tumor infiltrating CD8+ T cells directly induces apoptosis of mouse hepatocellular carcinoma. J Hepatol,2006,45(5):662-672.
    63. Liu L, Sakaguchi T, Kanda T, et al. Delivery of interleukin-12 in gelatin hydrogels effectively suppresses development of transplanted colonal carcinoma in mice. Cancer Chemother Pharmacol,2003,51(1):53-57.
    64. Yawalkar N, Karlen S, Hunger R, et al. Expression of interleukin-12 is increased in psoriatic skin. J Invest Dermatol,1998;111(6):1053-1057.
    65. Cheng J, Tu Y, Li J, et al. A study on the expression of interleukin(IL)-10 and IL-12 P35, P40 mRNA in the psoriatic lesions. J Tongji Med Univ, 2001;21(1):86-88.
    66. Lew W, Lee E, Krueger JG. Psoriasis genomics:analysis of proinflammatory (type 1)gene expression in large plaque(Western)andsmall plaque(Asian)psoriasis vulgaris. Br J Dermatol,2004;150(4):668-676.
    67. Lee E, Trepicchio WL, Oestreicher JL, et al. Increased expression of intedeukin 23 p19 and p40 in lesional skin of patients with psoriasis vulgaris. J Exp Med, 2004;199(1):125-130.
    68. Mossner R, Beckmann I, Hallermann C, et al. Granulocyte colony-stimulating-factor-induced psoriasiform dermatitis resembles psoriasis with regard to abnormal cytokine expression and epidermal activation. Exp Dermatol 2004;13(6):340-346.
    69. Toichi E, Torres G, McCormick TS, et al. An anti-IL-12p40 antibody dow-n-regulates type 1 cytokines, chemokines, and IL-12/IL-23 in psoriasis. J I mmunol 2006; 177(7):4917-4926.
    70. Arican O, Aral M, Sasmaz S, et al. Serum levels of TNF-alpha, IFN-gam ma, IL-6, IL-8, IL-12, IL-17, and IL-18 in patients with active psoriasis an d correlation with disease severity. Mediators Inflamm 2005(5):273-279.
    71. Krueger GG, Langley RG, Leonardi C, et al. A human interleukin-12/23 monoclonal antibody for the treatment of psoriasis. N Engl J Med 2007;356 (6):580-592.
    72. Nestle FO, Conrad C. The IL-12 family member p40 chain as a master switch and novel therapeutic target in psoriasis. J Invest Dermatol 2004;123(6):xiv-xv.
    73. Wong CK, Ho CY, Li EK, et al. Elevation of proinflammatory cytokine(IL-18, IL-17, IL-12)and Th2 cytokine(IL-4)concentrations in patients with syst emic lupus erythematosus. Lupus,2000,9:589-593.
    74.丁政云,李鑫,蔡丽,等.扁平苔藓皮损中白介素12p40的表达及外周血T细胞免疫功能检测[J].中华皮肤科杂志,2006,39(7):403-404.

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