중이 진주종 및 만성중이염에서 랑게르한스 세포에 관한 면역조직화학적 연구

Middle ear cholesteatoma is biologically invasive keratinizing squamous epithelial cyst that contains the desquamated debris. And it is clinically important entity because it causes destruction of adjacent bones and serious complications.

The pathogenesis and pathophysiology of cholesteatoma has been debated but there are basic theories of epithelial ingrowth and metaplasia of middle ear epithleium. Also there is concept that expanding process of desquamation causes bone destruction and that it may be due to proteolytic enzymes such as collagenase. Recent works suggest that Langerhans cells have an immunologic altering function and have a role of generating and maintaining the chronic inflammatory reacton which induces bone resorption.

The morphologic feature of cholesteatoma was similar to that of the tympanic membrane but there was a increase of Langerhans cells in cholesteatoma. Langerhans cells are the bone marrow-derived immune cells of the epidermis. They express la antigens and receptors for the Fc portion of IgG and complement components. Langerhans cells appear to recognize antigen and present them to T-lymphocyte and possibly macrophage.

The authors used immunohistochemical method to indentify and quantify distribution of Langerhans cells(S-100 protein), T-lymphocyte(HLA-DR, CD3) using monoclonal antibody techniques.

We compared distribution of Langerhans cells in cholesteatoma matrix, infected tympanic membrane and adjacent canal skin of chrnic otitis media of which were taken from patients during operation.

The obtained results were as follows :