破骨细胞分化因子在根尖周骨吸收中的作用机制研究

Study on the Mechanism of RANKL in Bone Absorption of Periapical Lesion

目的探讨根尖周骨吸收的机制。方法采用免疫组化SP法检测28例根尖囊肿及17例根尖肉芽肿组织中破骨细胞分化因子(RANKL)的表达,以10例正常口腔粘膜作对照,骨吸收体积采用骨腔注水法测定。并同时检测诱导型一氧化氮合酶(iNOS)的表达进行相关性研究。结果45例根尖周病损组织中RANKL与iNOS阳性表达率分别为48.9%与60.9%,而10例正常口腔粘膜RANKL与iNOS表达均为阴性,在RNKL表达阳性病例中iNOS阳性表达率为81.8%,两者有显著相关性(P<0.025)。在RANKL表达(-)^(+++)各组中骨吸收体积分别为:1.02±0.38ml、1.17±0.45ml、1.37±0.58ml和1.87±0.63ml;(-)与(+++)组间有显著性差异(P<0.001)。并且RANKL在根尖肉芽肿与根尖囊肿组织中的表达有显著性差异(P<0.05)。结论在根尖病损的骨吸收机理中,除炎性通路外,RANKL的过表达起着重要的作用。

Objective To investigate the molecular mechanism of bone absorption in periapical lesion. Methods With 10 cases of normal oral mucesa as control, immunohistcehemistry SP staining was used to evaluate the expression of ligand of receptor activator of NF-KB （RANKL） and inducible nitric oxide synthase （iNOS） in 28 cases of periapical cyst and 17 cases of periapical granuloma. Volumes of these cases were measured during operation. Results The positive rate of RANKL and iNOS in 45 cases were 48.9% （22/45） and 60.9% （28/45）, respectively. While no positive e^qgression was seen in 10 cases of normal oral mucosa. In the cases with positive expression of RANKL, the positive rate of iNOS was 81.8% （18/22）, there is significant positive relationship （P 〈 0.025） between them. Volumes in groups of different RANKL expression （ - ） - （＋ ＋ ＋ ） were 1.02±0.38ml, 1.17±0.45ml, 1.37±0.58ml and 1.87±0.63ml, respectively. Only between （ - ） and （ ＋ ＋ ＋ ） group there was significant difference （P〈0.001）. There was significant difference of RNAKL expression between periapical cyst and periapical granuloma （p 〈 0.05）. Conclusions Besides of inflammation pathway, the over-expression of RNAKL played a key role in bone absorption of periapical lesion.