结缔组织生长因子在硬皮病患者皮损中的表达及其作用探讨

Expression of Connective Tissue Growth Factor in Skin Lesions in Patients with Scleroderma

目的探讨结缔组织生长因子(CTGF)在硬皮病(SD)发病机制中的作用及其与SD分型、分期的关系。方法分别采用原位RT-PCR和免疫组化SABC法检测36例SD〔其中系统性硬化症(SSc)29例,局限性SD 7例;水肿硬化期28例,萎缩期8例〕皮损中CTGF mRNA与蛋白的表达,并以20例正常皮肤组织作为对照。结果SD组CTGF mRNA(阳性表达率:80.6%vs 40.0%,P=0.002;范围强度积分:2.67±1.33 vs 1.30±1.03,P<0.01)与蛋白(阳性表达率:88.9%vs 45.0%,P<0.001;范围强度积分:2.83±1.06 vs 1.40±1.10,P=0.001)表达阳性率和范围强度均高于正常对照组。SSc组CTGF mRNA与蛋白表达阳性率和范围强度与局限性SD组间差异均无统计学意义。SD水肿硬化期皮损中CTGF mRNA(阳性表达率:89.3%vs 50.0%,P=0.030;范围强度积分:2.89±0.99 vs 2.00±1.20,P=0.039)与蛋白(阳性表达率:96.4%vs 62.5%,P=0.028;范围强度积分:3.07±0.86 vs 2.00±1.31,P=0.009)表达阳性率和范围强度均高于萎缩期皮损。结论CTGF在SD发病机制中起重要作用,与皮肤纤维化的发展密切相关,局限性SD和SSc发病机制可能相似。

Objective To identify the role of connective tissue growth factor （CTGF） in the pathogenesis of scleroderma （SD） and its association with different types and stages of SD. Methods The expression of CTGF mRNA and proteins in the skin lesions of 36 patients with SD （including 29 SSc, 7 localized SD; 28 eases at edema and sclerosis stage, and 8 cases at atrophy stage） was detected with in situ RT-PCR and immuno-histoehemical SABC respectively, Twenty normal skin tissues served as controls. Results The SD patients had higher positive rate and field-strength score of the expression of CTGF mRNA and proteins than the controls, No significant differences were found in the positive rate and field-strength score of the expression of CTGF mRNA and proteins between localized SD and SSc. The SD patients at the edema and sclerosis stage had higher positive rate and fieldstrength score of the expression of CTGF mRNA and proteins than those at the atrophy stage. Conclusion CTGF plays an important role in the pathogenesis of SD and it is closely associated with the development of the pathologic fibrotic process. Localized SD and SSc may have similar pathogenesis.