急性呼吸窘迫综合征患者肺组织Fas/FasL系统表达的变化及其意义

The significance of Fas/FasL system in lung tissue in patients with acute respiratory distress syndrome

目的：探讨细胞凋亡在急性呼吸窘迫综合征（ＡＲＤＳ）发病中的作用及基因调控机制，为进一步阐明ＡＲＤＳ的发病机制和在细胞凋亡水平防治本病提供理论依据。方法：ＡＲＤＳ组９例，对照组５例，采用ＴＵＮＥＬ法以及免疫组化技术观察ＡＲＤＳ患者肺组织Ｆａｓ／ＦａｓＬ系统表达及细胞凋亡的变化。结果：ＡＲＤＳ早期患者肺组织细胞凋亡率较对照组明显增加，且主要表现为肺泡上皮和肺血管内皮细胞凋亡增加；Ｆａｓ抗原、ＦａｓＬ在ＡＲＤＳ早期患者肺组织表达明显上调，并且Ｆａｓ、ＦａｓＬ表达的增加与肺组织细胞凋亡增加呈平行关系。结论：肺泡上皮和肺血管内皮细胞凋亡增加和Ｆａｓ／ＦａｓＬ系统活化可能参与临床ＡＲＤＳ早期的发病。

Objective:To evaluate the effects of apoptosis and expression of apoptotic related genes on acute respiratory distress syndrome (ARDS).Methods:By using TUNEL,histopathology and immunocytochemistry techniques,apoptosis and Fas,FasL protein expression were studied in patients with ARDS in acute stage compared with those in control subjects.Results:Apoptosis ratio and Fas/FasL protein expression in lung tissues were significantly higher in patients with ARDS than in normal controls.Also,pulmonary Fas/FasL protein expression was elevated along with the increase in apoptosis ratio.Conclusions:During the acute stage of ARDS,apoptosis of alveolar epithelial cells and pulmonary vascular endothelial cells,and activation of Fas/FasL system may contribute to the pathogenesis of this syndrome.