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Doctoral Thesis
DOI
10.11606/T.5.2013.tde-24062013-102845
Document
Author
Full name
Charles Antonio Pires de Godoy
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2013
Supervisor
Committee
Capelozzi, Vera Luiza (President)
Aguiar, Lana Maria de
Malheiros, Denise Maria Avancini Costa
Palmeira, José Arnaldo Vasconcelos
Petri, Valéria
Title in Portuguese
Estudo da expressão do colágeno tipo V e sua relação com a proteína 1 da matriz extracelular no remodelamento da pele de pacientes com líquen escleroso
Keywords in Portuguese
Colágeno
Hialina
Imunofluorescência
Líquen escleroso
Microscopia confocal
Proteínas da matriz extracelular
Abstract in Portuguese
Introdução: O remodelamento da matriz extracelular no líquen escleroso (LS) caracteriza-se histologicamente por uma faixa hialinizada situada predominantemente na derme superficial, semelhante ao que ocorre na lipoidoproteinose (LPE), uma genodermatose rara, na qual ocorre deficiência na produção da proteína 1 da matriz extracelular (ECM-1). Recentemente, em casos de LS foram descobertos auto-anticorpos contra a ECM-1 e um novo caminho foi proposto para desvendar a sua etiopatologia. O LS também é freqüentemente comparado com a Esclerodermia, visto que alguns autores consideram que são espectros de uma mesma doença. Na Esclerodermia e na LPE há aumento do colágeno tipo V (COL V), mas pouco se sabe sobre este tipo de colágeno no LS. Assim, o objetivo do presente trabalho foi demonstrar a localização e a quantidade de COL V e ECM-1 nas vulvas de pacientes com LS. Materiais e métodos: foram estudadas 21 biópsias de pacientes com LS vulvar e 21 biópsias de vulvas normais. A morfometria foi realizada nas imagens geradas através da imunofluorescência marcada com anticorpos contra os colágenos I (COL I), III (COL III) e V, e também nas de imunoistoquímica para ECM-1. Ademais, utilizou-se microscopia confocal a laser para visualizar o COL V e a ECM-1 na mesma lâmina. Resultados: Peles do grupo controle mostraram fraca e homogênea distribuição das fibras de COL I, III e V na imunofluorescência. Em contraste, peles com LS exibiram desarranjo da arquitetura da derme superficial e difuso aumento da fluorescência das fibras de COL I, III e V na faixa hialina. A fração de área das fibras de COL I, III, e V foram significativamente maiores nas peles de pacientes com LS em relação ao controle (p<0,05). Peles controles mostraram co-localização da ECM-1 e do COL V na parede de pequenos vasos e ao longo da membrana basal. Entretanto, no LS houve perda de expressão da ECM-1 na parede dos vasos sanguíneos (p<0,001) e difuso aumento da fluorescência verde do COL V (p<0,001). Conclusão: Houve inversa relação entre o COL V e a proteína ECe constatado pela histomorfometria, imunofluorescência, imunoistoquímica e reconstrução tridimensional, sugerindo que estratégias terapêuticas para prevenir o aumento da síntese de COL V e a diminuição da ECM-1 poderão ser promissoras no prognóstico e tratamento do LS
Title in English
Study the expression of type V collagen and its relation to extracellular matrix protein 1 remodeling the skin of patients with lichen sclerosus
Keywords in English
Collagen
Confocal microscopy
Extracellular matrix proteins
Hyalin
Imunofluorescence
Lichen sclerosus
Abstract in English
Background: The extracellular matrix remodeling in lichen sclerosus (LS) is characterized in routine light microscopy by a hyalinized band predominantly located in the superficial dermis. The same pattern occurs in the lipoid proteinosis (LPE), a rare genodermatosis, in which the production deficiency of extracellular matrix protein 1 (ECM-1) is responsible for triggering the disease. Recently, in cases of LS, autoantibodies were discovered against ECM-1 and a new way to unravel their aetiopathology was proposed. LS is also frequently compared with Scleroderma, since some authors consider that they are spectra of a similar disease. In Scleroderma and LPE there is an increase of type V collagen (COL V), but little is known about this type of collagen in LS. Thus, the objective of the current study was to demonstrate the location and quantity of COL V and ECM-1 on the vulvas of patients with LS. Materials and methods: Twenty one biopsies from patients with vulvar LS matched with 21 biopsies from normal vulvas were included in this study. Immunofluorescence against type I (COL I), (COL III) and V collagen and immunohistochemistry for ECM-1 was performed and the slides were analysed by morphometry. Furthermore, laser confocal microscopy was used to visualize the COL V fibers and the ECM-1 protein on the same slide. Results: Skins of the control group showed low and homogeneous distribution of fibers COL I, III and V in immunofluorescence. In contrast, skins with LS exhibited disruption of the architecture of the superficial dermis and diffuse increase in fluorescence fibers COL I, III and V in the range hyaline. The area fraction of fibers COL I, III, and V were significantly higher in the skin of patients with LS compared to control (p <0.05). Skins controls showed colocalization of ECM-1 and COL V the wall of small vessels and along the basement membrane. However, the LS had loss of expression of ECM-1 the wall of blood vessels (p <0.001) increase the fluorescence and diffuse green COL V (p <0.001). Conclusion: There was an inverse relationship between COL V and ECM-1 protein in LS as demonstrated by histomorphometry, immunofluorescence, immunohistochemistry and three-dimensional reconstruction, suggesting that therapeutic strategies to prevent the increased synthesis COL V and ECM-1 protein in LS as demonstrated by histomorphometry, immunofluorescence, immunohistochemistry and three-dimensional reconstruction, suggesting that therapeutic strategies to prevent the increased synthesis COL V and decreased ECM-1 may be promising in the prognosis and treatment of the LS
 
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Publishing Date
2013-10-21
 
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