失禁相关性皮炎并金黄色葡萄球菌感染对皮肤组织Gasdermin D蛋白的影响

Effect of incontinence-associated dermatitis and Staphylococcus aureus infection on Gasdermin D protein in skin tissues

目的探讨失禁相关性皮炎(IAD)并金黄色葡萄球菌感染对皮肤组织中Gasdermin D蛋白的影响。方法选择医院泌尿外科2018年10月-2020年10月进行手术并在术后发生失禁相关性皮炎患者,根据是否存在金黄色葡萄球菌感染从中选择患者各50例,分为感染组和非感染组,采用失禁相关性皮炎严重程度评估工具对病情严重程度进行评估。使用一次性无菌棉签刮取病灶处细菌,恒温培养后根据菌落计数结果对感染组进行分组。采用免疫组化法检测皮肤组织Gasdermin D、NF-κB蛋白相对表达,采用酶联免疫吸附法检测血清中白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平。结果感染组Gasdermin D、NF-κB、IL-1β、IL-6和TNF-α水平高于非感染组,差异具有统计学意义(P<0.05);病情严重组Gasdermin D、NF-κB、IL-1β、IL-6和TNF-α水平高于病情较轻组,差异具有统计学意义(P<0.05);高菌落计数组Gasdermin D、NF-κB、IL-1β、IL-6和TNF-α水平高于低菌落计数组,差异具有统计学意义(P<0.05)。结论金黄色葡萄球菌可能通过上调Gasdermin D后激活NF-κB通路及其下游促炎细胞因子的方式造成皮肤感染,引发IAD。

OBJECTIVE To explore the effects of incontinence-related dermatitis and Staphylococcus aureus infection on Gasdermin D protein in skin tissues.METHODS Dermatitis patients for surgery and with postoperative incontinence-associated dermatitis in the Urology Department of our hospital from Oct 2018 to Oct 2020 dermatitis patients were enrolled.According to whether S.aureus infections occurred,they were divided into the infection group and non-infection group,50 patients in each group.Incontinence-associated dermatitis and its severity instrument(IADS)was used to evaluate the severity of the disease.Bacteria from the lesion were scratched by disposable sterile cotton swabs,and were cultured at constant temperature to count the colonies,in accordance of which the infection group was divided into subgroups.The relative expression of Gasdermin D and NF-κB protein in skin tissue was detected by immunohistochemical method,and the serum interleukin-1β(IL-1β),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)levels were determined by enzyme-linked immunosorbent assay.RESULTS Gasdermin D,NF-κB,IL-1β,IL-6 and TNF-αlevels in the infection group were significantly higher than those in the non-infected group(P<0.05).The gasdermin D,NF-κB,IL-1β,IL-6 and TNF-αlevels in the severely ill group were significantly higher than those in the milder disease group(P<0.05).Gasdermin D,NF-κB,IL-1β,IL-6 and TNF-αlevels in the high colony count group were significantly higher than that in the low colony count group(P<0.05).CONCLUSION Staphylococcus aureus may cause skin infections and cause incontinence-related dermatitis by activating the NF-κB pathway and its downstream pro-inflammatory cytokines after upregulating Gasdermin D.