Changes of Langerhans cells in skin lesions and its immune mechanism in patients with Neisseria gonorrhoeae infection combined with condyloma acuminatum after PDT treatment
Objective To observe the changes of Langerhans cells(LCs)in the skin lesions and its immune mechanism in patients with Neisseria gonorrhoeae(NG)infection and condyloma acuminatum(CA)after photodynamic therapy(PDT).Methods A total of 103 patients with NG infection combined with CA admitted to our hospital from March 2018 to March 2021 were prospectively enrolled as observation subjects and divided into observation group(n=53)and control group(n=50)randomly,with 5 male individuals who came to our hospital for circumcision during the same period in-cluded as the normal group.The control group was treated with CO2 laser,and the observation group was treated with PDT,while the normal group was not treated.Enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of IL-2 and IFN-γ in the peripheral blood of patients before and after treatment,and the clinical efficacy,recurrence rate,incid-ence of adverse reactions and the distribution of 21 human papillomavirus(HPV)genes were compared between the two groups.Fifty-three cases of CA skin lesion tissue before and after PDT treatment and 5 cases of normal foreskin tissue were stained with immunohistochemical staining method,and the number and morphology of LCs were observed under high-power light microscope to analyze the immune mechanism.Results(1)The total efficiency rate(98.11％)in the observa-tion group was significantly higher than the 84.00％in the control group(P＜0.05).(2)The total recurrence rate of dis-eases and the total incidence rate of adverse reactions in the observation group were 7.55％and 5.66％,respectively,signi-ficantly lower than those in the control group(32.00％and 40.00％,respectively)(all P＜0.05).(3)After treatment,the levels of IL-2 and IFN-γ in the observation group were significantly higher than those in the control group(all P＜0.05).(4)The low-risk HPV infection rate,high-risk infection rate,mild-risk HPV infection rate,combined HPV infection rate in 103 patients with NG infection combined with CA were 57.28％(59/103),14.56％(15/103),5.83％(6/103)and 22.33％(23/103),respectively;the HPV clearance rate(83.02％)in the observation group after treatment was significantly higher than the 52.00％in the control group(P＜0.05).(5)Before treatment,the number of LCs in the epidermis in observation group was significantly lower than that in the normal group,and the cell body was smaller than that in the normal group,with irregular distribution;most LC structures were incomplete and did not have the typical characteristics of LCs;some le-sions had no LCs in epidermis,but atypical LCs were seen in dermis.(6)In the observation group,the number of LCs be-fore treatment was significantly less than that in the normal group,which increased immediately after treatment and re-turned to the baseline level 7 days after treatment.The positive CD1a cell density was 6.48％in the normal group,signific-antly higher than in observation group before and after treatment(all P＜0.05).Conclusion Photodynamic therapy has significant clinical effect in patients with NG infection combined with CA;the recurrence rate and incidence of adverse re-actions are low.It can positively regulate the levels of IL-2 and IFN-γ in peripheral hematoma of patients,participate in body-specific immune response,and change the number and morphology of LCs in skin lesions.
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