肿瘤坏死因子-α在溃疡性结肠炎中的表达及其作用探讨

Expression and Effect of Tumor Necrosis Factor-α in Ulcerative Colitis

背景:随着肿瘤坏死因子(TNF)-α单克隆抗体治疗克罗恩病(CD)获得成功,TNF-α在CD发病机制中的作用已得到肯定,但其在溃疡性结肠炎(UC)中的作用尚需进一步研究。目的:探讨TNF-α在UC中的表达及其与疾病活动性和组织学分级的关系,研究TNF-α在UC中的作用。方法:35例UC患者和15例对照者经结肠镜取活检,标本分别用于组织学诊断、分级和原位杂交检测结肠黏膜TNF-αmRNA的表达。根据Powell-Tuck评分系统对UC患者作疾病活动性评分。结果:UC黏膜TNF-αmRNA阳性细胞百分率较对照组显著增高(P<0.01),但其表达与疾病活动性和组织学分级无相关性(P>0.05)。表达TNF-αmRNA的炎性细胞多分布于远离上皮层的固有层下部。结论:UC黏膜TNF-αmRNA的表达确有增高,但与疾病活动性和组织学分级均无明确关系。TNF-α在UC发生、发展过程中的作用尚不肯定。

Background： With the success of anti-tumor necrosis factor （TNF）-α monoclonal antibody used in the management of Crohn＇s disease （CD）, the effect of TNF-α in the pathogenesis of CD had been confirmed, but its role in ulcerative colitis （UC） needs further investigation. Aims： To investigate the expression and effect of TNF-α in UC, as well as its relationship with the activity and histological grade of UC. Methods： Fifty biopsy specimens were obtained endoscopically from 35 patients with UC and 15 controls, respectively. The specimens were used for diagnosis and histological grading, as well as in situ hybridization for TNF-α mRNA in colonic mucosa. The disease activity index of UC was graded according to PowellTuck scoring system. Results： The percentage of immunopositive cells for TNF-α mRNA in UC mucosa was increased considerably as compared with that in the controls （P〈0.01）, but there was no correlations between TNF-α mRNA expression and the disease activity or histological grade of UC （P〉0.05）. In UC mucosa, TNF-α mRNA-positive inflammatory cells were mainly localized at the basal area of lamina propria, which were far away from the epithelial lining. Conclusions： The expression of TNF-α mRNA in UC mucosa increases considerably, but no exact relationship is found between its expression and the disease activity or histological grade. The effect of TNF-α in the development of UC remains uncertain.