糖皮质激素受体α和β与突发性聋治疗的相关性

Study on the relationship between GRα、GRβ-isoform of glucocorticoid receptors and glucoeorticoid sensitivity in sudden sensorineural hearing loss

目的探讨糖皮质激素受体α(glucoeoaicoid receptors,GRα)和β(GRβ)在突发性聋(sudden sensorineural hearing loss,SSHL)糖皮质激素抵抗中的分子生物学机制。方法选择我科住院的SSHL患者83例,根据疗效分为治疗无效组和治疗敏感组,对照组为我科10例鼻中隔偏曲患者。应用逆转录聚合酶链反应法检测治疗无效组、治疗敏感组SSHL患者及对照组外周血单个核细胞GRα、GRβ mRNA的表达水平,以探讨GRα、GRβ与SSHL糖皮质激素抵抗的关系。结果全部入选对象均有GRα mRNA和GRβ mRNA表达,GRα mRNA表达量高于GRβ mRNA,但治疗敏感组、治疗无效组和对照组之间GRα mRNA表达量比较,差异无统计学意义(t=1.813,0.184,P均>0.05)。3组间GRβ mRNA表达量比较,治疗无效组明显高于治疗敏感组和对照组,差异有统计学意义(t=3.440,3.942,P均<0.05);而治疗敏感组和对照组比较,差异无统计学意义(t=1.359,P>0.05)。3组间GRα/GRβ比值比较治疗无效组明显低于治疗敏感组和对照组,差异有统计学意义(t=-3.326,-3.383,P均<0.05)。结论在突发性聋患者中,GR亚型在外周血单个核细胞中表达量与糖皮质激素疗效密切相关,检测GRα和GRβ表达量及比值可作为预测糖皮质激素治疗反应的重要指标。

OBJECTIVE To identify the relationship between the expression of α and β-isoforms of glucoeoaicoid receptors（GR）and response to glucoeorticoid in the patients with sudden sensorineural hearing loss（SSHL）.METHODS The 83 patients with SSHL and 10 deviated septum control group were devided into 3 groups（treatment sensitive group,treatment invald group and control group）according to the response to the treatment with corticosteroid,RT-PCR was used to detect the expression of GRα、GRβ in PBMC among 83 patients with SSHL and 10 deviated septum controls.RESULTS The expression of GRα and GRβ mRNA in PBMC among the three groups,and the expression of GRα is higher than that of GRβ;but the expression of GRα mRNA in the two groups of SSHL had no statistical significance compared to the normal（t=1.813,0.184,average P0.05）;The expression of GRβ mRNA in the treatment invald group of SSHL was significantly higher than that in both the treatment sensitive group and control group（t=3.440,3.942,average P0.05）;but there were no statistical significance in expression of GRβ mRNA between the treatment sensitive group and control group comparison of SSHL（t=1.359,P0.05）;The ratio of the GRα/GRβ in the treatment invald group of SSHL was decreased than that of the treatment sensitive group and control group（t=-3.326,-3.383,average P0.05）.CONCLUSION Both GRα、GRβ and the ratio of GRα/GRβ play an important role in the mechanism of the action of glucocorticoid in patients with SSHL.The expression of GRα、GRβ and the ratio of GRα/GRβ on PBMC in patients with SSHL may serve as predictors of glucocorticoid response.