感染后肠易激综合征患者结肠黏膜P物质与白细胞介素、干扰素表达的相关性研究

Study on the relationship between substance P and expressions of interleukin and interferon on colonic mucosa in patients with post-infective irritable bowel syndrome

目的探讨肠道感染对肠易激综合征(IBS)患者结肠黏膜P物质(SP)、Th1细胞因子表达的影响。方法经结肠镜钳取77例IBS(20例感染后)患者及30例对照者的降结肠和直肠黏膜标本,采用免疫组化染色法检测肠黏膜SP与白细胞介素(1L)-2、干扰素(IFN)-γ的表达情况。结果IBS伴腹泻型患者结肠黏膜SP、IFN-γ和IL-2表达与对照组间差异有统计学意义(P＜0．05),感染后IFN-γ和IL- 2阳性的IBS伴腹泻型患者结肠黏膜SP表达与对照组间差异亦有统计学意义(P＜0．05),而非感染后IBS患者结肠黏膜IFN-γ和IL-2阳性SP表达与对照组间差异无统计学意义(P＞0．05),但有增加趋势。结论感染可促进SP表达增加,进而促使Th1细胞因子表达上调。感染可通过黏膜免疫/肠神经系统改变参与IBS发病。

Objective To investigate the effect of infection on the expression of substance P（SP） and Th1 cytokine on colonic mucosa in patients with irritable bowel syndrome（IBS）. Methods Mucosa biopsy samples were obtained in descending colon and rectum from 77 patients （20 post-infective-IBS cases） and 30 controls by colonoscopy. The expressions of SP,interleukin（IL）-2,interferon（IFN）-γ were determined by immunohistochemical staining. Results Compared with controls, expressions of SP,IL-2 and IFN-γ were significantly increased in IBS patients with diarrhea-predominant （P 〈 0.05）, and expression of SP in post-infective-IBS patients with cytokines positive（IL-2 and IFN-γ） were also significantly increased （P 〈 0.05）. There were no significant differences between non post-infective-IBS and controls. Conclusions Expression of SP was significantly increased in post-infective-IBS. SP upregulated the expression of Thl cytokines （IL-2 and IFN-γ）. Gastrointestinal infection may involve in the pathogenesis of IBS through neuroimmune mechanism.