变应性鼻炎鼻黏膜组织重塑的研究

To study of the nasal mucosa remodeling of allergic rhinitis patients

目的:探讨变应性鼻炎(AR)鼻黏膜组织是否存在重塑,检测与组织重塑密切相关的转化生长因子β1(TGF-β1)、基质金属蛋白酶9(MMP-9)及其组织抑制物1(TIMP-1)在AR患者鼻黏膜组织中的表达情况。方法:15例单纯性鼻中隔偏曲患者为对照组,16例鼻中隔偏曲伴轻度间歇性AR的患者为轻度AR组,12例鼻中隔偏曲伴重度持续性AR的患者为重度AR组。均取中鼻甲黏膜组织,苏木精-伊红染色观察嗜酸粒细胞浸润情况并测定上皮损伤情况;AB-PAS法计数杯状细胞数,MT法测定细胞外基质沉积面积百分比,ELISA测定组织中TGF-β1、MMP-9及TIMP-1的表达。结果:①对照组无明显嗜酸粒细胞浸润,轻度、重度AR组嗜酸粒细胞浸润均较对照组明显增多(均P<0.05);②轻度AR组中仅上皮细胞损伤1级比对照组明显(P<0.05),重度AR组上皮损伤1、2、3级均比对照组明显(均P<0.05);③轻度、重度AR组杯状细胞数明显多于对照组(均P<0.05);④与对照组相比,轻度AR组胶原沉积面积增多,但差异无统计学意义(P>0.05);重度AR组胶原沉积面积比对照组明显增多(P<0.05);⑤TGF-β1、MMP-9及TIMP-1在轻度、重度AR组黏膜中的表达均较对照组增高(均P<0.05);重度AR组TGF-β1和TIMP-1的表达均比轻度AR组增高(均P<0.05)。结论:AR的鼻黏膜组织发生了重塑,表现为上皮细胞损伤、杯状细胞化生、细胞外基质沉积,重度AR患者的鼻黏膜重塑更强、更广泛,TGF-β1、MMP-9、TIMP-1积极参与了AR鼻黏膜组织的重塑。

Objective：To explore whether there was tissue remodeling in the nasal mucosa of allergic rhinitis（AR） patients and detect the protein expressions of transforming growth factor β1（TGF-β1）,matrix metall oproteinases 9（MMP-9） and tissue inhibitors of matrix metall oproteinases 1（TIMP-1）in the nasal mucosa of these patients.Method：Pathologic staining was used to explore the mucosa of the middle turbinate tissues from 16 patients with mild AR,from 12 patients with severe AR,and from 15 non-AR,respectly.The infiltrating of eosinophils and damage of epithelium were examined by the hematoxylin-eosin staining;goblet cells were counted by the alcian blue-periodic acid-schiff staining;the percentage area of extracellular matrix was determined by the MT;the protein expressions were measured by ELISA of TGF-β1,MMP-9 and TIMP-1 in the middle turbinate tissues.Result：Compared with the control group,significant eosinophil infiltration and goblet cells were observed in both AR groups（P0.05）.Eevident epithelial damage and extracellular matrix deposition were observed in severe-AR group（P0.05）.The expressions of TGF-β1,MMP-9 and TIMP-1 in AR tissues were significant increased（P0.05）.Conclusion：The nasal mucosa remodeling was observed in AR groups.The characteristics were as follows：eosinophils infiltration,epithelial damage,goblet cells hyperplasia and extracellular matrix deposition.TGF-β1,MMP-9,TIMP-1 may play a role in the tissue remodeling processes.