马拉色菌相关疾病研究现状

马拉色菌感染是皮肤科常见的真菌感染性疾病,其中花斑癖的发病与该菌属存在着直接的相关性,目前研究表明脂溢性皮炎、特应性皮炎、马拉色菌毛囊炎、银屑病等相关疾病的发生与发展与马拉色菌属的感染存在着一定的联系。本研究综述结合相关文献报道,对马拉色菌属在一些常见皮肤疾病中的发病机制和相关致病机制作了一定概述。     

马拉色菌相关疾病的现状与研究进展

马拉色菌是人类及温血动物皮肤上的正常菌群之一,其与花斑癣、马拉色菌毛囊炎、脂溢性皮炎、银屑病等多种疾病的相关性日益受到关注,作者对马拉色菌的分类及其相关疾病的发病机制、病因、临床表现及诊断作一综述。     

马拉色菌在特应性皮炎免疫学发病机制中的研究进展

近年来,对马拉色菌与免疫系统之间关联的研究明显增加,其重要内容是马拉色菌在特应性皮炎发病中的作用。本文主要概述近期一些研究中对马拉色菌与树突状细胞、角质形成细胞间的关联性及其在特应性皮炎发病的免疫学机制中的作用所获得的进展。     

马拉色菌的免疫学与分子生物学研究新进展

马拉色菌是一组常见的条件致病菌,属于嗜脂性酵母。马拉色菌与许多皮肤疾病的相关性逐渐受到重视,特别是免疫学与分子生物学方面的研究,为马拉色菌相关皮肤疾病的诊断提供了更为简便、可靠的依据。现对马拉色菌在皮炎的发病机制、诊断、治疗等方面的免疫学与分子生物学研究进展作一综述。     

马拉色菌致病相关因子的研究进展

马拉色菌是人类和温血动物皮肤的常驻菌,亦是一种条件致病性真菌,它可以引起花斑癣、马拉色菌毛囊炎、脂溢性皮炎等多种疾病。脂酶、蛋白酶、磷脂酶和脂氧合酶等为马拉色菌主要侵袭性酶。马拉色菌与角质形成细胞共培养可引起角质形成细胞多种形态学改变、细胞因子含量变化和细胞凋亡。     

头颈部特应性皮炎患者面部马拉色菌的菌种分布

目的探讨马拉色菌(Malassezia)在头颈部特应性皮炎(atopic dermatitis, AD)患者中面部菌种分布以及与严重程度之间的关系。方法 2020年9月—12月共招募45例AD患者和50名健康志愿者,无菌棉签对患者和志愿者面部皮损区和非皮损区分别进行皮肤鳞屑取样,用荧光实时定量PCR的方法检测两组人群的7种马拉色菌的拷贝数,进行菌种分布以及数量的横断面分析。结果头颈部AD患者面部皮损区限制马拉色菌和球形马拉色菌的拷贝数分别为健康志愿者的3.13倍(P0.05)和6.69倍(P0.05),两者皆与患者AD病情严重度相关(P0.05)。结论头颈部AD患者面部皮损区限制马拉色菌和球形马拉色菌含量均高于健康人,两者含量均与AD患者病情严重程度相关。     

东南亚青年人群中马拉色菌菌种构成分析

目的：研究部分东南亚国家青年人群中马拉色菌菌种构成。方法采集285名青年人（分别来源于中国、尼泊尔、印度、巴基斯坦）面部正常皮肤及皮损区标本,接种于 Leeming ＆amp; Notman 培养基后进行培养分离,生化及形态学方法鉴定到种。结果共分离出8个菌种,共计501株马拉色菌,以球形马拉色菌为主,占40.5℅（203/501）,其次为合轴马拉色菌19.0℅（95/501）、糠秕马拉色菌16.0℅（80/501）、限制马拉色菌11.0℅（55/501）、斯洛菲马拉色菌6.2℅（31/501）等。各国家间未见明显的地理学差异。结论东南亚地区青年正常人群及马拉色菌相关疾病患者中的主要菌种为球形马拉色菌。     

南海海军部队特发性瘙痒症患者皮肤马拉色菌定植调查

目的研究南海海军部队特发性皮肤瘙痒症患者皮肤马拉色菌的检出以及菌种的构成,探讨马拉色菌与特发性瘙痒症之间的相关性。方法对采自56例特发性瘙痒症患者与50例健康者的鳞屑标本进行真菌学镜检及采用菜子油培养基培养,根据菌落形态和生理生化特点进行菌种鉴定。结果观察组与对照组镜检阳性率分别为74．10％和72．00％,X2=0．344,P〉0．05两者比较无统计学意义。而镜检马拉色菌孢子密度Ⅲ级以上（每10个高倍视野≥50个者）,观察组与对照组分别为74．70％和38．89％,X2=20．30,P〈0．01。两者统计学比较差异有显著性意义。观察组168份标本共分离出143株马拉色菌,阳性率85．12％。其中合轴马拉色菌97株（67．83％）,球形马拉色菌26株（18．18％）,糠秕马拉色菌19株（13．29％）,钝形马拉色菌1株（0．70％）。对照组分离出马拉色菌107株,阳性率71．33％;其中糠秕马拉色菌55株（51．40％）,合轴马拉色菌33株（30．84％）,球形马拉色菌14株（13．08％）,钝形马拉色菌5株（4．67％）。菌种检出率和菌种构成差异均有显著性（X2=2．99,P〈0．01和7。X2=51.16,P〈0．01）。结论南海海军部队特发性瘙痒症患者皮肤马拉色菌载量较正常人高,其优势菌是合轴马拉色菌。     

马拉色菌感染的光学治疗研究进展

马拉色菌是寄生在人体和动物皮肤上的一种真菌,当机体抵抗力低下或某种诱因存在时,马拉色菌可大量繁殖导致机体皮肤和或其附属器官感染致病。马拉色菌感染机体皮肤可出现红斑、丘疹等皮损,皮损症状可影响患者的正常生活,并造成一定的心理负担。治疗以口服抗真菌药为主,但其具有肝损伤、消化系统症状等药物不良反应,长期用药可致继发感染及耐药产生。近年安全、有效的光学疗法治疗真菌性皮肤病被广泛推荐,该文对马拉色菌感染的光学治疗研究进展进行综述,以期为该病的预防治疗提供一定参考。     

马拉色菌相关人群及正常人群耳耵聍中马拉色菌带菌情况的调查

目的调查马拉色菌相关人群及正常人群耳耵聍中马拉色菌带菌情况。方法用结晶紫染色法对96例被调查人群耳耵聍进行马拉色菌检测,同时作培养,并以标准株作对照,用生理生化方法将耵聍中分离到的79株马拉色菌进行分类。结果马拉色菌相关人群耳耵聍中马拉色菌的直接检出率为91．84％（45／49）,培养阳性率为81．63％（40／49）,其中厚皮马拉色菌8株（16．33％）,合轴马拉色菌10株（20．41％）,糠秕马拉色菌22株（44．90％）。正常人群耳耵聍马拉色菌直接检出率为89．36％（42／47）,培养阳性率为78．72％（37／47）,其中厚皮马拉色菌5株（10．64％）,合轴马拉色菌8株（17．02％）,糠秕马拉色菌23株（48．93％）,斯洛菲马拉色菌1株（2．13％）。结论马拉色菌为正常人群及马拉色菌相关人群外耳道正常菌群,两组人群中马拉色菌的分离率和菌种分布无显著性差异。     

Recent developments in the immunology and biology of Malassezia species

Malassezia spp. are members of the normal cutaneous flora, but are also associated with several cutaneous diseases. Recent studies of the interaction of Malassezia spp. with melanocytes, fibroblasts, keratinocytes and dendritic cells have highlighted their potential to modulate the immune response directed against them. In normal skin they may downregulate the inflammatory response, allowing them to live as commensals. In contrast, in atopic/eczema dermatitis syndrome and psoriasis, they may elicit an inflammatory response that contributes to the maintenance of lesions. Future research may define ways to influence this inflammatory cycle and hence to control or prevent exacerbations of these diseases.     

Cytokines as therapeutic targets in skin inflammation

This review focuses on treatment targets for the most common inflammatory skin diseases, eczema and psoriasis with an emphasis on cytokines expressed in the uppermost layer of the skin which is easily accessible for diagnostic and therapeutic approaches. Recently, a significant body of research has highlighted the influence of the skin barrier and the patients’ microbiome on skin inflammatory responses and we will comment on their impact on mediator regulation. Itch is a prominent dermatology symptom which is influenced by cytokines and can via itch–scratch cycle impact on the skin barrier and mediator expression associated with damage. Taking the contribution of pruritus and superficial skin damage into account, we address cytokines as targets for stratified treatment approaches in subgroups of eczema and psoriasis.     

益生菌对特应性皮炎的防治及机制研究进展

特应性皮炎(atopic dermatitis, AD)是一种以反复发作和严重瘙痒为特征、发病率最高的过敏性皮肤病。AD的致病机制涉及遗传易感性、表皮屏障功能障碍、微生物组失调、免疫反应失衡以及环境等多个因素,而现有治疗用药副作用大、疗效欠佳。目前研究已发现肠道菌群尤其是益生菌在AD中起着重要作用。益生菌能够通过抑制病原菌、增强屏障功能、改善肠道环境和平衡Th1/Th2免疫应答等机制改善AD症状。本文综述了AD患者皮肤及肠道微生态特征,基于AD发病的致病机制和影响因素,系统阐明益生菌缓解AD的机制,以期为益生菌治疗AD及相关皮肤过敏性疾病提供理论支持。     

Malassezia Baillon, emerging clinical yeasts

The human and animal pathogenic yeast genus Malassezia has received considerable attention in recent years from dermatologists, other clinicians, veterinarians and mycologists. Some points highlighted in this review include recent advances in the technological developments related to detection, identification, and classification of Malassezia species. The clinical association of Malassezia species with a number of mammalian dermatological diseases including dandruff, seborrhoeic dermatitis, pityriasis versicolor, psoriasis, folliculitis and otitis is also discussed.     

Humoral immune response to Malassezia furfur in patients with pityriasis versicolor and seborrheic dermatitis

Humoral immune responses against exoantigen components of oval, elliptic and round yeast forms of Malassezia furfur were analysed by ELISA and Western blotting assays, using sera from patients with pityriasis versicolor (PV), seborrheic dermatitis (SD) and healthy adults (HA), as control. Sera from patients with SD showed IgG anti-oval M. furfur titers ranging from 1/400 to 1/6400 showing geometric mean (GM) of 1/1472, higher than those obtained with sera from patients with PV (1/200 to 1/6400, GM = 1/1239). Both patient groups showed mean titres statistically superior (p < 0.05) than those obtained from HA (GM = 1/229). Similar data were also obtained with the elliptic and round antigens. However, the anti-oval IgG mean titers from patients' sera were much higher than those obtained with elliptic or round antigenic components (p < 0.05). Anti-M. furfur IgM titers obtained from patient's sera with PV against all three exoantigens were statistically superior (p < 0.05) than HA group. Patients with SD showed IgM titers statistically superior (p < 0.05) only to oval yeasts of M. furfur. The IgA mean titers from patients' groups against the different morphological antigens were shown be slightly higher than those HA group. By Western blot, using rabbit anti-sera, the different antigenic components of M. furfur showed a close relationship mainly between oval and elliptic yeast cells antigens. The 70 kDa component of the M. furfur exoantigen of oval morphology was recognized by 84% of the PV patients' sera. On the other hand, SD patients' sera recognized 3 principal components of 70 kDa (100%), 65 kDa (67%) and 84 kDa (53%). These components may be considered immunological markers for PV and SD. Twenty-five percent of HA sera recognized the components of 65, 70 and 94 kDa. This investigation shows that M. furfur antigens can sensitize the host, mainly the oval yeast form of M. furfur with a very important specific IgG response in patients with SD and PV. This revised version was published online in June 2006 with corrections to the Cover Date.     

Chemokine-Like Factor 1 (CLFK1) Is Over-Expressed in Patients with Atopic Dermatitis

Background: Human chemokine-like factor 1 (CKLF1), a recently discovered chemokine, has a broad spectrum of biological functions in immune-mediated diseases. It is highly expressed on Th2 lymphocytes and is a functional ligand for human CCR4. CKLF1 has a major role in the recruitment and activation of leucocytes, which plays an important role in the pathogenesis of allergic diseases. The present study was designed to determine the expression of CKLF1 in skin and serum in patients with atopic dermatitis (AD).Methods: The CKLF1 protein expression in skin lesion was analyzed by immunohistochemistry and ELISA. The mRNA expression of CKLF1 in skin lesion was detected by Real-time PCR. The serum levels of CKLF1, IgE, eotaxin, IL-4, IL-5, and IL-13 were measured by ELISA.Results: Histopathological changes in the skin of AD patients showed local inflammation with epidermal thickening and significant inflammatory cellular infiltration. Immunohistochemistry results demonstrated that CKLF1-staining positive cells were located in the epidermal and dermis, and that the CKLF1 expression in AD patients was significantly higher than that in normal control. The CKLF1 mRNA expression in AD patients was significantly higher than that in healthy controls. Serum CKLF1 and IgE levels were significantly increased in AD patients, as were the serum levels of IL-4, IL-5, IL-13 and eotaxin.Conclusions: Both CKLF1 protien and mRNA levels are overexpressed in the skin lesion of AD patients, along with an increase in serum CKLF1 level, indicating that CKLF1 may play an important role in the development of atopic dermatitis.     

Lipidomic analysis of epidermal lipids: a tool to predict progression of inflammatory skin disease in humans

Introduction: Lipidomics is the large-scale profiling and characterization of lipid species in a biological system using mass spectrometry. The skin barrier is mainly comprised of corneocytes and a lipid-enriched extracellular matrix. The major skin lipids are ceramides, cholesterol and free fatty acids (FFA). Lipid compositions are altered in inflammatory skin disorders with disrupted skin barrier such as atopic dermatitis (AD).

Areas covered: Here we discuss some of the recent applications of lipidomics in human skin biology and in inflammatory skin diseases such as AD, psoriasis and Netherton syndrome. We also review applications of lipidomics in human skin equivalent and in pre-clinical animal models of skin diseases to gain insight into the pathogenesis of the skin disease.

Expert commentary: Skin lipidomics analysis could be a fast, reliable and noninvasive tool to characterize the skin lipid profile and to monitor the progression of inflammatory skin diseases such as AD.     

复方苦参洗剂联合伊曲康唑治疗马拉色菌毛囊炎临床观察

目的 了解复方苦参洗剂联合伊曲康唑治疗马拉色菌毛囊炎的疗效.方法 将马拉色菌毛囊炎患者48例随机分为治疗组和对照组,各24例.两组均口服伊曲康唑胶囊200 mg,1次/d,疗程为2周,治疗组同时加用复方苦参洗剂外洗4周为1个疗程,2次/d.分别于开始治疗2周后及8周后观察皮疹消退情况和马拉色菌镜检结果,评价其疗效.结果 治疗2周时,治疗组总有效率75.0％,对照组总有效率41.7％,两组总有效率比较差异有统计学意义（x2=5.49,P＜0.05）,8周时,治疗组总有效率91.7％,对照组总有效率62.5％,两组有效率比较差异有统计学意义（x2=5.78,P＜0.05）.结论 复方苦参洗剂联合伊曲康唑治疗马拉色菌毛囊炎疗效显著,值得临床推广.     

Genotyping by RAPD-PCR analyses of Malassezia furfur strains from pityriasis versicolor and seborrhoeic dermatitis patients

Malassezia furfur is lypophilic yeast commonly associate with dermatological disorders. In the present work, we described the isolation of 47 M. furfur strains from three groups of patients: pityriasis versicolor (21 isolates), seborrhoeic dermatitis (15 isolates) and seborrhoeic dermatitis of the HIV positive patients (11 isolates). To investigate the identity of the strains at molecular level, DNA genomic of M. furfur strains were prepared and used to RAPD-PCR analyses. RAPD assay were carried out using two decamer primers and bands pattern generated were analyzed by an Unweighted Pair-Group Method (UPGMA). Dendrogram established a distinct differentiation between M. furfur isolates from pityriasis versicolor and seborrhoeic dermatitis patients with or without AIDS. We concluded that RAPD typing presented a high discriminatory power between strains studied in this work and can be applied in epidemiological investigation of skin disease causing by M. furfur.