Mukaddes Eşrefoğlu, Muammer Seyhan, Akın Aktaş, Mehmet Gül, Feral Öztürk

Psöriatik Deride Histopatolojik Bulgular ve Laminin ve Fibronektin Dağılımı

Amaç: Yapılan bazı çalışmalarda psöriatik deride keratinosit proliferasyonu ve farklılaşmasında anahtar rol oynayabilecek bazı önemli bazal membran değişiklikleri olduğu gösterilmiştir. Laminin α1 zinciri ve fibronektin dağılımındaki değişiklikler keratinosit büyümesini etkileyerek psöriasisin başlamasından sorumlu olabilir. Bu görüş doğrultusunda çalışmamızda psöriatik deride dermis, epidermis ve dermo-epidermal bileşkedeki yapısal değişikliklerin yanısıra laminin ve fibronektin dağılım örneğini de incelemeyi amaçladık. Gereç ve Yöntem: Ondört erkek psöriasis vulgaris hastası ve 6 sağlıklı gönüllü retrospektif olarak değerlendirildi. Psöriasisli hastalar kronik ve stabil plakları olan, tedavi almamış hastalardı. Kesitler haematoxylin ve eosin (H-E) ve periodic acid Schiff (PAS) yöntemleri ve laminin ve fibronektin kitleri kullanılarak immunohistokimyasal olarak boyandı. Bulgular: Psöriatik derinin histolojik incelenmesinde rete çıkıntılarında uzama, parakeratoz, epidermal intersellüler ödem, mononükleer hücrelerin epidermise geçişi ve dermiste mononukleer hücre infiltrasyonu saptandı. PAS yöntemiyle bazal membranda geniş kesintiler gözlendi. Psöriatik deride bazal membranda laminin zayıf, kesintili ve düzensiz bir dağılım örneği gösterdi. Fibronektin bazal membran altında belirgindi, dermisde fibriler veya retiküler bir boyanma örneği gösterdi. Sonuç: Çalışmamızın sonuçları psöriasisin patogenezinde bazal membran değişiklikleri ile birlikte laminin ve fibronektin dağılımındaki değişikliklerin önemli rol oynadığı hipotezini desteklemektedir. Anahtar kelimeler: Psöriasis, Laminin, Fibronektin, Bazal membran, Epidermis

Anahtar Kelimeler:

Psöriasis, Laminin, Fibronektin, Bazal membran, Epidermis

Histopathological Findings and the Distribution of Laminin and Fibronectin in Psoriatic Skin

Objective: Some previous studies have shown important modifications of the basement membrane of psoriatic skin, which could play a key role in alterations of keratinocyte proliferation and differentiation. Changes in distribution of the laminin α1 chain, together with fibronectin, might influence keratinocyte growth, and thus could be responsible for the initiation of psoriasis. In the view of these considerations, we have aimed to determine the expression pattern of laminin and of fibronectin, besides the structural alterations of the epidermis, dermis, and dermoepidermal junction in involved psoriatic skin. Material and methods: Fourteen male psoriasis vulgaris patients and 6 healthy volunteers were studied retrospectively. All psoriatic patients had chronic and stable psoriatic plaque, which had not been treated. Sections were stained with haematoxylin and eosin (H-E), and periodic acid Schiff (PAS) reagent, and were stained immunohistochemically using laminin and fibronectin kits. Results: Histological examination of psoriatic skin showed elongated rete ridges, parakeratosis, epidermal intercellular oedema, exositosis of mononuclear cells into the epidermis, and mononuclear cell inflammation in the dermis. PAS staining revealed the large interruptions of the basement membrane. In psoriatic skin samples, the staining of laminin showed discontinuous, weak, and an uneven disruption in the basement membrane. Staining for fibronectin was pronounced below the basement membrane and showed a reticular or fibrillar pattern in the dermis. Conclusion: The results of our study support the hypothesis that basement membrane alterations together with the alterations in the distribution pattern of laminin and fibronectin may play an important role in the pathogenesis of psoriasis. Key words: Psoriasis, Laminin, Fibronectin, Basement membrane, Epidermis

Keywords:

Psoriasis, Laminin, Fibronectin, Basement membrane, Epidermis,

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Correspondence Address:
Prof. Dr. Mukaddes Eşrefoğlu
Inönü University Medical Faculty,
Department of Histology and Embryology
Malatya/TÜRKİYE
Tel : 422 341 0660-1306 Fax : 422 341 0036
E-mail : drmukaddes@hotmail.com