嗜铬粒蛋白A在扩张型心肌病中的表达

The expression of chromogranin A in Dilated cardiomyopathy

目的观察扩张型心肌病(DCM)患者外周血及心肌组织中嗜铬粒蛋白A(CGA)的表达,初步探讨CGA在DCM发生发展中的作用。方法收集DCM患者及正常健康志愿者外周血血清,用ELISA方法检测样本血清中CGA水平。取DCM心脏移植患者的心肌组织样本,以及排除心脏疾病的脑外伤尸检心肌组织标本。利用RT-PCR技术检测心肌中CGA的mRNA在DCM心肌和正常心肌中的表达变化;应用免疫组化鉴定心肌中CGA的分布位置及其表达强弱变化。结果ELISA显示DCM患者外周血中CGA浓度为187.6±94.7ng/ml;正常健康志愿者外周血中CGA为130.6±21.1ng/ml(P<0.05)。和正常对照心肌相比,RT-PCR证实DCM心肌组织中CGA-mRNA表达升高(P<0.001)。免疫组化表明在DCM心肌中CGA颗粒粗大、部位密集,与正常心肌样本比较有统计学意义(P<0.05)。结论作为神经内分泌活性强有力指标的CGA在DCM心肌及血循环中表达均升高,提示CGA可能参与了DCM的发病。

Objective To observe the expression of chromogranin A （CGA） in peripheral blood and myocardium of patients with Dilated cardiomyopathy （DCM） , in order to investigate the role of CGA in the development of DCM. Methods The serum of DCM patients and healthy volunteers was collected, and then its concentration of CGA was detected with enzyme linked immunosorbent assay （ELISA）. Surgical myocardial specimen from DCM patients who were underwent successful orthotopic cardiac transplantation, and the normal myoeardiom were used for controls. CGA-mRNA was determined by RT-PCR in both normal and pathologic myocardium. And the location and expression of CGA were assessed by immunohistochemistry （INH）. Results Serum concentration of CGA was elevated in peripheral blood of DCM patients （ 187.6 ± 94.7ng/ml）, while its mean level in volunteers was 130.6 ± 21. lng/ml（ P 〈0.05 ）. CGA-mRNA was detected by RT-PCR in both normal and pathologic myocardium, while its expression was significantly increased in DCM （ P 〈 0.001 ）. Cytoplasic expression of CGA assessed by INH was showed that lots of strong positive granules were produced in DCM slides （ P 〈 0.05 ） , densely arranged in the epicardial and endocardial myocardiocytes; while only few sparse granules were found in the normal myocardium. Conclusion The expression of CGA is elevated in both peripheral blood and myocardium of patients with DCM, which indicated that CGA may influence the development of DCM.