转化生长因子-β1／Smad信号转导在强直性脊柱炎骶髂关节中表达的研究

Expression of transforming growth factor beta and Smad signalling in ankylosing spondylitis

目的了解强直性脊柱炎（AS）骶髂关节中转化生长因子（TGF）-β1，smad信号转导通路中主要分子的表达情况，探讨TGF-β1／Smad信号转导在As发病机制中的作用。方法53例As患者均检测血清TGF-β1及红细胞沉降率（ESR）、C反应蛋白（CRP）水平。其中30例行CT导引下穿刺活检取得骶髂关节组织，通过免疫组织化学方法，检测TGF-β1、p-Smad3、Smad7的表达。采用多个样本均数的单因素方差分析、两样本均数的t检验以及Kolmogorov—Smimov检验进行统计学处理。结果As患者中ESR／CRP升高组血清TGF-β1（15．9±5．6）ng/ml，较健康对照组、ESR／CRP健康组1（5．4±5．8）ng/ml和（4．1±3．6）ng／ml]均明显升高。与健康对照组相比，As骶髂关节组织可见TGF-β1高表达，主要在血管翳中炎症细胞的胞质中表达；Smad7明显低表达；D—smad3则主要表达于骨髓及血管翳中炎症细胞的细胞核中，提示smad3已被激活。结论As中存在TGF-β1的过高表达，Smad信号通路的激活，Samd7的低表达，可能与AS骶髂关节炎症活动、软骨的纤维化变性有关。

Objective To investigate the expression of transforming growth factor beta （TGF-β1） and Smad signaling in ankylosiug spondylitis （AS） and to explore their roles in the pathogenesis. Methods Fifty- three patients with AS were included in the study. In these 53 cases, 30 patients were performed computed tomography-guided needle biopsy in sacroiliac joint. Serum TGF-β1 was determined by enzyme-linked immunosorbent assay （ELISA）. Immunohistological studies were performed with the streptavidin-peroxidase conjugated methods to assess the expression of TGF-β1, p-smad3 and Smad7 in sacroiliac joint tissue sample. One-way ANOVA, two independent samples t test and kolmogoorov-Simirnov test were used to do statistical analysis. Results In 53 cases patients with AS, 20 cases were with high level Erythro-cyte sedimentation rate （ESR） and C-reactive protein （CRP）, while those of the other 33 cases were normal. Serum average TGF-β1 level [ （15.9±5.6 ） ng/ml ], in patients with high level ESR/CRP [ （5.4±5.8） ng/ml ] was significantly increased as compared to the controls and patients with normal ESR/CRP [（4.1±3.6） ng/ml] （P〈0.05）. There was no expression of TGF-β1 could be detected in the pannus and bone marrow in SI joints tissue of 30 cases with AS, while decreased level of smad7 expression was detected. In addition, p-smad3 expression was found in the nuclear. Conclusion TGF-β1 signaling may play an important role in the inflammatory erosion and cartilage fibrosis of sacroilitis in AS.