风湿性心脏病乳头肌TGF-β1和活化蛋白-1表达的意义

Expression of transforming growth factor-β1 and activator protein-1 in papillary muscles of patients with rheumatic heart disease

目的 探讨转化生长因子 - β1( TGF- β1)和活化蛋白 -1( AP- 1)在风心病心肌纤维化中的作用 .方法 取风心病二尖瓣乳头肌 ,以成人及胎儿正常乳头肌为对照 ,以 HE和Masson染色对心肌进行病理形态学观察 ,免疫组化染色观察TGF-β1和 AP- 1在心肌中的表达 ,用图像分析仪定量分析 .结果 风心病心肌间质胶原明显增生 ,呈网格状包绕心肌细胞 ,心肌内小血管内膜增生 ,管腔狭窄甚至闭塞 .TGF- β1和 AP- 1在风心病及胎儿心肌中表达阳性 ,在正常心肌中表达弱阳性或阴性 ;二者在病变心肌中的表达强度均与心肌纤维化面积呈显著正相关 ( r分别为 0 .8174和 0 .6 82 1,P<0 .0 1) .结论 TGF- β1和 AP-

AIM To observe the pathological changes in myocardium of rheumatic heart disease (RHD), so as to investigate the effects of transforming growth factor beta1 (TGFβ1) and activator protein1 (AP1) on rheumatic myocardial fibrosis. METHODS The papillary muscles samples were obtained from patients with RHD during mitral valve replacement. Normal papillary muscle samples were obtained from adult and fetal hearts during autopsy in control group. The specimens were stained with HE and Masson staining to observe the pathological changes; and immunohistochemically stained to examine the expression and distribution of TGFβ1 and AP1. Imaging analysis was employed to measure the area of myocardium fibrosis and the degree of immunohistochemical staining. RESULTS Myocardium of RHD showed significant collagen hyperplasia which surrounded and separated the myocardium, and endotheliosis with lumen stenosis, even occlusion of the small artery in myocardium. TGFβ1 and AP1 were positively expressed in rheumatic myocardium, and their expression was correlated positively with the area of myocardial fibrosis (r=0.8174, P<0.01; r= 0.6821 , P<0.01). CONCLUSION TGFβ1 and AP1 not only take part in but also play an important role in myocardial fibrosis with RHD.