α_1肾上腺素受体亚型在正常输尿管中下段的分布及其临床意义

Detection of α_1-Adrenoceptor Subtypes in Medial and Distal Regions of the Human Ureter and the Clinical Significance

目的:通过对人正常输尿管中下段中α_1肾上腺素受体(α_1-AR)亚型mRNA表达情况的研究,了解其各个亚型的分布相对丰度。方法:获取30例病理证实为正常的输尿管中下段,分别取输尿管中段(横跨髂血管处),输尿管下段(输尿管横跨髂血管处与膀胱壁间段之间的中点处),及膀胱壁间段组织,采用实时荧光定量RTPCR方法,检测α_(1a)-AR、α_(1b)-AR及α_(1d)-AR mRNA表达情况。结果:α_1-AR亚型在输尿管中段,下段和壁间段的表达均为α_(1d)-AR>α_(1a)-AR>α_(1b)-AR(42%:32%:26%,51%:26%:23%,56%:24%:20%,P<0.01)。α_(1d)-AR、α_(1α)-AR和_(1b)-AR在输尿管各段的分布均为壁间段>下段>中段(3.8:2.3:1,2.2:1.5:1,2.1:1.6:1,P<0.01)。结论:输尿管中下段存在α_1-AR的各个亚型。从输尿管中段至膀胱壁间段,各受体亚型mRNA表达呈逐渐上升趋势,其中α_(1d)-AR mRNA表达最多。提示以α_(1d)-AR阻滞为主的药物治疗输尿管中下段结石可能比以α_(1a)-AR阻滞为主的药物有更好的疗效。

Objective：To characterize the alphal-adrenoceptor （α1-AR） subtype gene expression in medial and distal regions of the human ureter. Methods：A total of 30 normal ureter specimens proved by pathology were utilized in the study. The quantitative expression of α1a-AR, α1B-AR and α1d-AR mRNA in medial, distal and intravesi- cal regions of the human ureter were determined using real-time quantitative reverse transcriptase-polymerase chain reaction （RT-PCR）. Results：Whether in the medial and distal ureter or in the intravesical region, the expression level of ARs was α1d〉α1a〉α1b（42% ： 32% ： 26%,51% ： 26% ： 23%,56% ： 24%：20%,respectively,P〈0. 01）. The distribution of α1d-AR, α1a-AR and α1b-AR in each ureteral region was intravesical region〉 distal ureter〉 medial ureter （3.8 ： 2.3 ： 1,2.2 ： 1.5 ： 1,2.2 ： 1.5 ： 1,respectively,P〈0.01）. Conclusions：Our results show that all the α1-AR subtypes are located in the medial and distal ureter. The expression levels of all three subtypes are increased gradually from the medial ureter to the intravesical region. Among these the expression level of α1-AR subtype is the most. These results suggest that selective alphalD-blockers have more efficacy than selective alphalA-blockers in management of medial and distal ureteral stones.