糖皮质激素性高眼压患者外周血单个核细胞糖皮质激素受体α和β的表达

Expression of glucocorticoid receptors α and β in mononuclear cells of peripheral blood in patients with glucocorticoid-induced ocular hypertension

目的探讨糖皮质激素性高眼压（GIOH）患者外周血单个核细胞（PBMCs）中糖皮质激素受体（GR）亚型GRα和GRβ的表达及其与GIOH发病的关系。方法病例对照研究。共有32例GIOH患者接受PBMCs检测，原发疾病为过敏性结膜炎。根据GIOH患者局部使用糖皮质激素滴眼液（0．1％地塞米松）后眼压变化水平，分为GIOH组[眼压升高8mmHg（1mmHg=0．133kPa）以上]和对照组（眼压升高不足8mmHg），每组各16例。采用半定量逆转录-聚合酶链反应（RT-PCR）法，检测GIOH组和对照组患者PBMCs中GRα mRNA、GRβ mRNA表达水平（以半定量比值表示）；采用荧光标记流式细胞技术，检测GIOH组与对照组患者PBMCs中GRα和GRβ蛋白含量（以细胞阳性率表示）。应用SPSS13．0统计学软件，对组间患者PBMCs中GRα mRNA和GRβ mRNA表达半定量比值和细胞阳性率进行比较，采用t检验，以P〈0．05作为差异有统计学意义。结果RT-PCR法检测，GIOH组患者PBMCs中GRα mRNA半定量比值为（1．152±0．057），与对照组（1．048±0．031）相比明显增高，差异有统计学意义（t=3．872，P〈0．05）；GIOH组患者PBMCs中GRβ mRNA半定量比值为（1．055±0．034），与对照组（1．063±0．035）相比，差异无统计学意义（t=0．419，P〉0．05）。荧光标记流式细胞技术检测，GIOH组患者PBMCs中GRα蛋白表达阳性率为（93．10±7．35）％，对照组为（46．00±13．11）％，两组间差异有统计学意义（t=8．513，P〈0．01）；GIOH组患者PBMCs中GRβ蛋白表达阳性率为（12．50±4．18）％，对照组为（23．83±3．92）％，两组间差异有统计学意义（t=4．842，P〈0．01）。结论GIOH组患者PBMCs中GRα mRNA和蛋白表达水平高于非高眼压患者，GRβ mRNA和蛋白表达水平低于非高眼压患者，提示PBMCs中GR mRNA和蛋白表达水平可能与GIOH的易感性有关。

Objective To study the expression of glucocorticoid receptors （α and β） in mononuclear cells of peripheral blood （PBMCs） in patients with glucocorticoid-induced ocular hypertension （GIOH） and the relationship between of the expression of GRα and GRβ in PBMCs and its susceptibility to GIOH. Methods Case control study. Thirty-two patients with anaphylactic conjunctivitis were enrolled in this study. All of whom were received topical application of 0. 1% dexamethasone. The patients with the elevation of intraocular pressure （IOP） over 8 mm Hg（ 1 mm Hg =0. 133 kPa） or higher within two weeks were defined as GIOH and the others were considered as control group. There were no statistical difference in sex, average age, and baseline IOP between two groups. Each group consisted of sixteen patients. GRα and GRβ mRNA （relative value ） in PBMCs were detected with semi-quantitative reverse transcriptional polymerase chain reaction （RT-PCR）, GRα and GRβ protein （positive ratio） in PBMCs examined with fluorescent labelling flow cytometry. Results The GRα mRNA/GAPDH ratio of GIOH group was significantly （t=3. 872 ,P 〈 0. 05） higher than that of control group （1.152±0. 057 vs 1.048±0.031）. The GRβ mRNA/GAPDH of GIOH group was lower than that of controI group＇s （ 1. 055 ±0. 034 vs 1. 063±0. 035 ）, but was not statistically different （ t = 0.419, P 〉 0. 05 ）. GRα positive percentage was significantly （t = 8. 513 ,P 〈 0. 01 ） higher in PBMCs of GIOH group than that of the control group （93.10 ± 7.35 ） % vs （46.00 ± 13.11 ） % , whereas GRβ positive percentage was significantly （ t = 4. 842 P 〈 0. 01 ） lower in PBMCs of GIOH group than that in control group （ 12. 50 ±4. 18 ） % vs （23.83 ±3.92） %. Conclusions The higher expression of GRα in PBMCs in patients may have an implication of susceptibility to GIOH and warrant further investigation.