慢性鼻窦炎术后不同疗效患者鼻黏膜β-防御素对比观察

Expression of human beta-defensin after endoscopic sinus surgery for chronic sinusitis

目的检测慢性鼻窦炎鼻内镜术后不同疗效患者术前和术后鼻黏膜中β-防御素(hBD-1和hBD-2)基因和蛋白质表达水平差异,并与正常对照组比较,探讨hBD-1和hBD-2在慢性鼻窦炎鼻内镜术后愈合过程中的意义。方法采用半定量RT-PCR和Westernblotting,对慢性鼻窦炎鼻内镜术后痊愈、有效和无效3种不同疗效患者与正常对照组术前和术后1周、2周、1月、3月、6月共6个时间段进行鼻黏膜hBD-1和hBD-2基因和蛋白质表达水平的检测和对比观察。结果 hBD-1和hBD-2在正常和慢性鼻窦炎黏膜中均有表达,但其水平呈现个体差异并与患者术后的疗效有关。hBD-2呈现不同的表达(P<0.05),表达水平明显与患者预后相关;hBD-1呈现个体差异,但其差异不明显并与患者预后无明显关系。结论在治愈组鼻黏膜中hBD-2mRNA和蛋白质水平均明显增加,故可能用作患者预后的判别指标之一。

Objective To observe the expressions of human beta-defensin 1 and 2 （hBD-1 and hBD-2） in nasal mucosa before and after the endoscopic sinus surgery and investigate the effects of hBD-1 and hBD-2 on the healing process after the surgery. Methods The patients undergoing endoscopic sinus surgery for chronic sinusitis were divided into 3 groups according to the response to the surgery, namely cured group, response group and non-response group. With those from healthy control subjects as the control, nasal mucosa samples were collected from the patients at 1 week, 2 weeks, 1 month, 3 months and 6 months after the surgery for detection of hBD-1 and hBD-2 mRNA and protein expressions by RT-PCR and Western blotting. Results hBD-1 and hBD-2 were expressed in both normal and chronic sinusitis mucosa, but the expression levels varied significantly between the individuals. The expression levels of hBD-2 was significantly correlated to the patients＇ response to the surgical treatment （P0.05）. hBD-1 showed slight differences between the individuals, but was not associated with the patients＇ prognosis. Conclusion The expressions of hBD-2 mRNA and protein are significantly increased in patients with good response to endoscopic sinus surgery for chronic sinusitis, suggesting the value of hBD-2 as an indicator of the patients＇ prognosis.