| Objective: lichen planus or lichen ruber planus is a kind of agnogenic chronic or subac infl desease of dermatic mucosa.Skin impairments are usually prunosus polygonal ancipital exanthemas and usually accompanied with buccal-mucosa impairments.It can be induced by many kinds of etiological factors, e.g. genetic factor, autoimmune factor, affectoi, psychic factor or medicamentous factor. The course of disease is long. Treatments are effective in general, though the exact mechanism of the treatment remain unknown. Resent study shows that the disease may be related to autoimmune dysfunction and delayed type hypersensitivity, etc. Histopathology performance of lichen planus is nonspecific inflammation: excessive Epidermal hyperkeratosis , focal thickening of wedge-shaped granular layer, irregular thickening of spine cell layer, liquefaction degeneration of basal cell and banded infiltration of the upper dermis(consisting mainly of lymphocyte). Nuclear factor kappa B or NF-κB is a widely distributed inducible transcription factor, which can be activated by virus product, cytokine, oxygen free radicals, ultraviolet and bacteria. It can participate in immune response, inflammatory response, cell growth differentiation and apoptosis etc physiological and pathological processes through controlling the related gene transcription. Resent studies show that NF-κB participate in the pathogenesis of a variety of skin diseases and become a focus of current dermatology researches. Vascular cell adhesion molecule-1 or VCAM-1 is a kind of important cell adhesion molecule and is a member of immunoglobulin family. Its main role is to activation of vascular endothelial cells. It is involved in a variety of immune response. It play an important role in inflammatory disease, autoimmune disease, cancer and allograft rejection. Very late anti-gen-4 or VLA-4 is a member of cell adhesion molecule integrin family. It mainly expresses itself in in the lymphocyte, monocyte, eosinophil and neutrophil cell surface and one of integrinα-subunit has a short cytoplasmic domain which can bind with many proteins an then connect with the cytoskeleton to form a signaling complex. which provide and critical costimulatory signal for activation of inflammatory cells. In addition VLA-4 is the receptor of VCAM-1 , its combination with lifands fibronectin and VCAM-1 is a critical step of inflammatory-cell adhesion and migration to extravascular organizations. It participates in whole process of triggering the leukocytes in inflammatory response and play an important role in many Many chronic inflammatory and autoimmune diseases. Present study shows VCAM-1 and VLA-4 mainly participate in the lymphocytes and vascular endothelial adhesion and tissue infiltration, thus resulting in the occurrence of this chronic inflammatory. Some researches discover that VCAM-1 and VLA-4 express themselves distinctly near the basal region of lichen planus lesions, which is consistent with the experimental results. So we can speculate that the two may also be involved in the vicinity of basal keratinocytes of the hyperplastic process. This experiment is to understand their respective role in the pathogenesis of LP and their mutual relationship and provide experimental basis for exploring the further details of the pathogenesis of LP.Methods:Thirty lesion cases diagnosed as LP clinically and histopathologically were collected from the dermatological department of the Fourth Affiliated Hospital of Hebei Medical University during Oct 2004 to Apr 2008, who had no other systemic diseases or dermatosis, and had not received any treatment since they were attracted. These cases included 12 males and 18 females, age arranged from 21 to 60 years (mean 35.90±1.84), course arranged from 2 to 24 months (mean 9.24±1.11). The fifteen normal controls were healthy volunteers in the hospital, and had no significant difference in sex, age and position between patients and controls.The levels of NF-kB,VCAM-1 and VLA-4's expression were measured by immunohistochemistry (SP). The results were analyzed by Mann-Whitney U rand sum test and Spearman's rank correlation test of SPSS 13.0 statistic software. Results:1 The pathology of 30 lesion cases of LP selected showed: excessive Epidermal hyperkeratosis (26/30); focal thickening of wedge-shaped granular layer (28/30);irregular thickening of spine cell layer (26/30); liquefaction degeneration of basal cell (15/30); banded infiltration of the upper dermis (30/30); telangiectasia in the superficial lamella of dermis (25/30);2 immunohistochemical results The positive cases were stained by Buffy grains.2.1 NF-κB was expressed on endochylema of keratinocyte in epidermis. Among these lesions of LP, there were 8 strongly positive cases, 15 positive cases, 7 weekly positive cases, 0 negative case. The level of its expression was markedly higher than the controls (P <0.01).2.2 VCAM-1 was expressed on endochylema of keratinocyte in epidermis and endothelial cell of blood vessel in dermis superficial layer. Among these lesions of LP, there were 4 strongly positive cases, 16 positive cases, 7weekly positive cases, 3 negative case. The level of its expression was markedly higher than the controls (P <0.01).2.3 VLA-4 was expressed on endochylema of keratinocyte in epidermis and endothelial cell of blood vessel in dermis superficial layer. Among these lesions of LP, there were 9strongly positive cases, 15 positive cases, 4 weekly positive cases, 2 negative cases. The level of its expression was markedly higher than the controls (P<0.01)2.4 The expression of NF-κB, VCAM-1, VLA-4 in LP was analogized by Spearman's rank correlation test: There was a positive correlation between the expression of NF-κB and VCAM-1. There was a positive correlation between the expression of NF-κB and VLA-4. There was a positive correlation between the expression of VCAM-1 and VLA-4.Conclusions:1 In this study, the level of NF-κB in the lesions in LP was higher than the controls. The higher expressions of NF-κB may lead to the hyperplastic process of the vicinity and the lymphocytes infiltration of in superficial lamella of the dermis.2 the level of VCAM-1 in the lesions in LP was higher than the controls. The higher expressions of VCAM-1 may participate in the lymphocytes and vascular endothelial adhesion and tissue infiltration. The higher expressions of VCAM-1 also may participate in liquefaction degeneration of basal cell and excessive Epidermal hyperkeratosis.3 There was a positive correlation of NF-κB and VCAM-1. They maybe take a common effect in excessive Epidermal hyperkeratosis and the lymphocytes infiltration of in superficial lamella of the dermis.4 The level of VLA-4 in the lesions was higher than that of controls. The up-regulation of VLA-4 maybe lead to the inflammatory-cell and vascular endothelial adhesion and tissue infiltration. The higher expressions of VLA-4 also may participate in liquefaction degeneration of basal cell and excessive Epidermal hyperkeratosis.5 There was a positive relation of NF-κB and VCAM-1, VLA-4 The up-regulation of NF-κB maybe promote the transcription of many factors including VCAM-1 and VLA-4. it mediates inflammatory reaction and excessive Epidermal hyperkeratosis...
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