急性冠状动脉综合征患者巨噬细胞表达过氧化体增殖物激活型受体γ及炎症相关因子的变化

Changes of Expression Levels of Peroxisome Proliferator-Activated Receptor-γ and Inflammatory Correlation Factors by Peripheral Blood Monocyte-Derived Macrophages in Patients with Acute Coronary Syndrome

目的探讨急性冠状动脉综合征患者外周血单核细胞源性巨噬细胞表达过氧化体增殖物激活型受体γ、核因子κB、基质金属蛋白酶9和组织型基质金属蛋白酶抑制剂1的变化及其间的关系。方法选取急性冠状动脉综合征患者48例、稳定型心绞痛患者22例为研究对象,抽取外周动脉血20mL,分离单个核细胞,加巨噬细胞集落刺激因子培养得单核细胞源性巨噬细胞;用CD40配体刺激后,酶联免疫吸附法测定上清液中基质金属蛋白酶9和组织型基质金属蛋白酶抑制剂1浓度,逆转录聚合酶链反应检测过氧化体增殖物激活型受体γ、基质金属蛋白酶9和组织型基质金属蛋白酶抑制剂1mRNA表达,免疫组织化学法检测核因子κB亚单位P65表达。结果急性冠状动脉综合征组过氧化体增殖物激活型受体γmRNA表达低于稳定型心绞痛组(0.24±0.04比0.39±0.06,P<0.001),核因子κBP65表达高于稳定型心绞痛组(0.42±0.06比0.27±0.02,P<0.001),基质金属蛋白酶9在上清液中的浓度及其mRNA表达明显高于稳定型心绞痛组(231.11±51.47μg/L比126.02±13.26μg/L和0.674±0.11比0.24±0.05,P<0.001),组织型基质金属蛋白酶抑制剂1在上清液中的浓度及其mRNA表达强度高于稳定型心绞痛组(139.80±31.54μg/L比112.25±12.68μg/L和0.42±0.09比0.33±0.06,P<0.05)。过氧化体增殖物激活型受体γmRNA表达与核因子κBP65和基质金属蛋白酶9的表达强度呈负相关(P<0.001),与组织型基质金属蛋白酶抑制剂1的表达强度不相关(P>0.05);核因子κBP65与基质金属蛋白酶9和组织型基质金属蛋白酶抑制剂1的表达强度呈正相关(P<0.001)。结论急性冠状动脉综合征患者外周血单核细胞源性巨噬细胞过氧化体增殖物激活型受体γ表达下调,核因子κB活性增强,基质金属蛋白酶9和组织型基质金属蛋白酶抑制剂1表达上调;过氧化体增殖物激活型受体γ可能通过调节核因子κB活性而调节基质金属蛋白酶9基因转录;但组织型基质金属蛋白酶抑制剂1表达可能不受过氧化体增殖物激活型受体γ调节。

Aim To explore the changes of peroxisome proliferator-activated receptor -γ （PPAR-γ） , nuclear factor-kB （ NF-kB ） , metalloproteinase-9 （ MMP-9 ） and metalloproteinase inhibitor-1 （ TIMP-1 ） expressed by peripheral blood monocyte-derived macrophages （ MDM ） in patients with acute coronary syndrome （ ACS ） and the relations among them. Methods 48 patients with ACS and 28 cases with stable angina pectoris （SAP） were admitted. A 20 mL fasting blood sample was obtained using a blood cell-separator tube. Peripheral blood mononuclear cells were isolated, and macrophage colony-stimulating factor was added to train them for MDM. After CD40 ligand stimulating, the concentrations of MMP-9 and TIMP-1 in the supernate of MDM and the expression strength of PPAR-γ, MMP-9, TIMP-1 mRNA and NF-KB subunit P65 （NF-kB P65 ） by MDM were determined. Results In ACS group, the expression strength of PPAR-γ mRNA was lower than the SAP group （0.24 ±0.04 vs 0.39 ±0.06; P 〈0.001 ） , while the expression strength of NF-kB P65 was higher than the SAP group （0.42 ± 0.06 vs 0.27 ± 0.02; P 〈 0.001 ）, both the concentration of MMP-9 and TIMP- 1 in the supernate of MDM were significantly higher than the SAP group （231.11 ± 51.47 μg/L vs 126.06 ± 13.2 μg/L, P 〈0.001 ; 139.80 ±31.54 μg/L vs 112. 250 vs 12.68 μg/L, P 〈0.05）, the expression strength of mRNA of MMP-9 and TIMP-1 were higher than the SA group （0.67 ± 0.11 vs 0.24 ± 0.05, P 〈 0.001 ; 0.42 ± 0.09 vs 0.33 ± 0.06, P 〈 0.05 ）. The expression strength of PPAR-γmRNA were negatively correlated to NF-kB P65 and the expression strength of MMP-9 （P 〈 0. 001 ）, but not correlated to the expression strength of TIMP-1 （ P 〉 0.05 ） ; the expression strength of NF-kB P65 were positively correlated to the expression strength of MMP-9 and TIMP-1 （ P 〈0. 001 ）. Conclusion For MDM of patients with ACS, the expression strength of PPAR-3, was down-regulated, while the expression strength of NF-KB and MMP-9 was up-regulated. The PPAR-γ may regulate MMP-9 expression before transcribed by regulating the activity of NF-kB. TIMP-1 expression may not be regulated by PPAR-γ.