摘要
目的 研究TNFR1和Bcl- 2在病理性瘢痕组织细胞中的表达及其对成纤维细胞凋亡与增殖的影响。方法 取手术切除的增生性瘢痕和瘢痕疙瘩患者各 15例标本 ,正常皮肤 12例标本 ,应用免疫组织化学方法进行检测 ,分析TNFR1和Bcl- 2的表达及分布规律。结果 TNFR1在正常皮肤、增生性瘢痕及瘢痕疙瘩中成纤维细胞的表达阳性率分别为 10 .70 %、3.2 3%和 7.72 % ,TNFR1在正常皮肤组中的阳性表达率明显高于增生性瘢痕组和瘢痕疙瘩组 ,而瘢痕疙瘩组阳性表达率却又明显高于增生性瘢痕组 ,三组间阳性表达率相互比较差异均有显著意义 (P <0 .0 1) ;Bcl- 2在增生性瘢痕组 (19.35 % )和瘢痕疙瘩组 (48.33% )的阳性表达率明显高于正常皮肤组 (4.0 7% ) ,三组间阳性表达率相互比较差异亦均有显著意义 (P <0 .0 1)。结论 Bcl- 2的持续过表达可能是瘢痕疙瘩呈瘤样增生的原因之一。介导的死亡受体凋亡通路受阻及TNFR1介导核转录因子NF -kB的激活 ,表明TNFR1对成纤维细胞的增殖与凋亡具有双重的调节作用。
Objective To study the different expression and significance of apoptosis-related TNFR 1 and Bcl-2 in fibroblasts derived from pathologic scar. Methods The expression and distribution of TNFR 1 and Bcl-2 were detected positive by immunohistochemistry in 12 normal skin, 15 hypertrophic scars and keloids. Results The positive cellular ratio in normal skin, hypertrophic scar and keloid were, respectively, 10.70%, 3.23% and 7.72% for TNFR 1. There were obvious difference in three groups (P<0.01). Especially, the expression of TNFR 1 in fibroblasts deprived from keloid was significantly elevated in compare with that from hypertrophic scar. The positive cellular ratio of Bcl-2 in keloid(48.33%) was notably elevated in compare with that in hypertrophic scar (19.35%) (P<0.01) and normal skin (4.07%) (P<0.01). Conclusion The formation of pathologic scar may be associated with the block of apoptotic way of TNFR 1 and the over expression of Bcl-2. Meanwhile, TNFR 1 perhaps activates the NF-kB, then the NF-kB accelerates the proliferation of fibroblasts. It indicates that TNFR 1 is possessed of double regulation for fibroblasts in apoptosis and proliferation.
