脑动静脉畸形显微手术后周围脑组织IL-17A、TGF-β表达水平及意义

Expressions of transforming growth factor-β and interleukin-17A in peripheral brain tissue of nidus after microsurgical resection of brain arteriverous malformations and their significance

目的观察白细胞介素-17A（IL-17A）及转化生长因子-β（TGF-β）在脑动静脉畸形（AVM）显微手术后灶周脑组织中表达的变化及意义。方法前瞻性观察25例脑AVM患者IL-17A、TGF-β表达情况，其中12例患者血管内栓塞治疗后行显微手术切除，设为栓塞组；13例行单纯显微手术切除，设为未栓塞组。6例对照组脑组织为来源于外伤及脑出血内减压术后的正常脑组织标本。采用免疫组化和RT-PCR技术，检测AVM灶周脑组织IL-17A、TGF-β蛋白及mRNA的表达。结果与对照组比较，栓塞组及未栓塞组灶周脑组织的IL-17A蛋白及其mRNA表达明显增加，差异有统计学意义（P〈0．05）：与未栓塞组比较，栓塞组IL-17A蛋白及mRNA表达明显减少，差异有统计学意义（P〈0．05）。与对照组比较，栓塞组与未栓塞组TGF-β蛋白及mRNA表达明显减少，差异有统计学意义（P〈0．051；与未栓塞组比较，栓塞组TGF-β蛋白升高不明显，差异无统计学意义（P〉0．05），TGB移mRNA明显升高，差异有统计学意义（P〈0．05）。结论IL-17A表达升高参与了AVM血管扩张及再通的临床病理过程，而TGF-β表达升高具有抑制栓塞后炎症反应的作用。

Objective To observe the expressions of interleukin-17A （IL- 17A） and transforming growth factor β （TGF-β） in the peripheral brain tissue of nidus after microsurgical resection of brain arterivenous malformations （AVM）, and their significance. Methods We prospectively chose 25 patients with AVM; 12 of them were performed endovascular embolization and then microsurgical removal （Group A）, and the other 13 were performed microsurgical removal only （Group B）. Another 6 patients with traumatic brain injury and hypertensive cerebral hemorrhage that needed internal decompression were used as controls. The expressions of IL-17A and TGF-β in these brain tissues were detected by immunohistochemistry and P,T-PCR. Results The protein and mRNA expressions of IL-17A in Group A and B were significantly increased as compared with those in the controls （P〈0.05）; the protein and mRNA expressions of IL-17A in Group A were significantly decreased as compared with those in Group B （P〈0.05）. The protein and mRNA expressions of TGF-β in Group A and B were significantly decreased as compared with those in the controls （P〈0.05）; the protein expression of IL-17A in Group A was not significantly increased as compared with that in Group B （P〉0.05）; the mRNA expression of IL-17A in Group A was significantly increased as compared with that in Group B （P〈 0.05）. Conclusion The increased expression of IL-17A might be associated with the growth and pathologic process of AVM; the increased expression of TGF-β might inhibit the inflammatory reaction after embolization.