Immunohistochemical Analyses of Monkeypox Skin Lesions with MPXV A29 and A35 Antibodies: A Novel Insight for Clinical-Histopathological Forms.

IF 1.3 4区 医学 Q4 INFECTIOUS DISEASES
Mei Shi, Chun-Yu Zhang, Dan-Yang Zou, Juan Wu, Nan-Hui Wu, Li-Yan Ni, Zhi-Fang Guan, Qian Du, Rui-Rui Peng, Fu-Quan Long
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Abstract

The aim of this study was to describe the clinical, histopathological, and immunohistochemical characteristics of MPX and offer meaningful insights into the clinicopathology of MPX. We recruited eight men who had sex with men diagnosed with MPX based on positive results from MPX Virus (MPXV)-specific polymerase chain reaction. Skin biopsies were obtained from four selected lesions, including typical and atypical lesions. Histopathological examinations of atypical solitary ulceration revealed infiltrating inflammatory cells predominantly composed of plasma cells and lymphocytes, forming a "sleeve" around the superficial vessels of the dermis. These features might be misinterpreted as indicative of cutaneous syphilis infection. Meanwhile, typical pustular lesions displayed central necrotic epidermis accompanied by perivascular inflammatory infiltrate dominated by neutrophils, as well as ballooning and reticular degeneration of keratinocytes. Additionally, multinucleated keratinocytes and eosinophilic cytoplasmic inclusions known as Guarnieri's bodies were also observed. Importantly, this study represented the pioneering report on immunohistochemical detection of MPXV A29 and A35 proteins in skin lesions, distinguishing it from previous studies that focused on detecting vaccinia virus protein. The anti-MPXV A29 antibody exhibited robust cytoplasmic staining specifically within affected keratinocytes in both adjacent epidermis and hair follicles, thereby it could contribute to the diagnosis of MPX, especially for cases with atypical skin lesions.

用 MPXV A29 和 A35 抗体对猴痘皮肤病变进行免疫组化分析:临床病理形式的新见解。
本研究旨在描述 MPX 的临床、组织病理学和免疫组化特征,为 MPX 的临床病理学提供有意义的见解。我们招募了八名根据 MPX 病毒(MPXV)特异性聚合酶链反应阳性结果被诊断为 MPX 的男男性行为者。我们选取了四个皮损部位进行皮肤活检,包括典型皮损和非典型皮损。非典型单发溃疡的组织病理学检查显示,浸润性炎症细胞主要由浆细胞和淋巴细胞组成,在真皮浅层血管周围形成一个 "套筒"。这些特征可能会被误认为是皮肤梅毒感染的表现。与此同时,典型的脓疱性病变表现为表皮中央坏死,伴有以中性粒细胞为主的血管周围炎症浸润,以及角质细胞气球化和网状变性。此外,还观察到多核角质细胞和嗜酸性细胞质包涵体(称为瓜尔尼里体)。重要的是,这项研究开创了免疫组化法检测皮肤病变中 MPXV A29 和 A35 蛋白的先河,有别于以往侧重于检测疫苗病毒蛋白的研究。抗 MPXV A29 抗体在邻近表皮和毛囊中受影响的角质细胞内均表现出特异性的强细胞质染色,因此有助于 MPX 的诊断,尤其是对非典型皮损病例。
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来源期刊
CiteScore
4.50
自引率
4.50%
发文量
172
审稿时长
2 months
期刊介绍: Japanese Journal of Infectious Diseases (JJID), an official bimonthly publication of National Institute of Infectious Diseases, Japan, publishes papers dealing with basic research on infectious diseases relevant to humans in the fields of bacteriology, virology, mycology, parasitology, medical entomology, vaccinology, and toxinology. Pathology, immunology, biochemistry, and blood safety related to microbial pathogens are among the fields covered. Sections include: original papers, short communications, epidemiological reports, methods, laboratory and epidemiology communications, letters to the editor, and reviews.
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