梗阻性黄疸患者肠黏膜损伤与肠黏膜IL-6、NF-κB、ICAM-1高表达的相关性

High expression of IL-6, NF-κB and ICAM-1 in the intestinal mucosa is associated with intestinal mucosal injury in patients with obstructive jaundice

目的: 观察梗阻性黄疸患者肠黏膜形态学及超微结构的变化, 探讨白细胞介素-6(interleukin-6, IL-6)、核因子κB(nuclear factorB, NF-κB)、细胞间黏附分子-1(intercellular adhesion molecule-1, ICAM-1)与梗阻性黄疸患者肠黏膜损伤的关系.方法: 应用光镜及电镜观察梗阻性黄疸患者肠黏膜形态学及超微结构的改变, 采用免疫组织化学方法检测肠黏膜IL-6、NF-κB和ICAM-1的表达情况.结果: 梗阻性黄疸组肠黏膜光镜下表现为绒毛排列紊乱, 变短或缺失, 绒毛间距变宽, 并可见上皮细胞及腺体坏死. 电镜下表现为连接复合体尚完整, 但微绒毛明显稀疏, 上皮柱状细胞扁平, 线粒体肿胀、嵴断裂、甚至空泡样变, 并可见细菌黏附在黏膜表面. 免疫组织化学结果显示与无黄疸组相比, 梗阻性黄疸组肠黏膜IL-6、NF-κB、ICAM-1的阳性表达明显增高, 其平均光密度值分别为(IL-6: 0.18±0.02, 0.13±0.01, P <0.05; NF-κB: 0.23±0.01,0.19±0.03, P <0.05; ICAM-1: 0.17±0.01, 0.13±0.02,P<0.05).结论: 梗阻性黄疸患者肠黏膜IL-6、NF-κB和ICAM-1表达增加与其肠黏膜损伤机制相关.

AIM： To observe the morphology and ultrastructure changes in the intestinal mucosa in patients with obstructive jaundice, and to investigate the relationship between the expression of inter-leukin-6 （IL-6）, nuclear factor κB （NF-κB） and intercellular adhesion molecule-1 （ICAM-1） and intestinal mucosal injury.METHODS： TThe morphology and ultrastructure changes in the intestinal mucosa in patients with obstructive jaundice were observed by lightmicroscopy and electron microscopy, respectively. The expression of IL-6, NF-κB and ICAM-1 in the intestinal mucosa was detected using immu-nohistochemistry.RESULTS： Light microscopy analysis revealed that, in patients with obstructive jaundice, the intestinal villi were arranged disorderly and became shorter or absent, the intervals of villi were widened, and necrosis of the enterocytes and glands were visible. Electron microscopy analysis showed that, although the junctional complexes appeared intact, the microvilli were loose, the enterocytes became flat, the mitochon-dria swelled up and even become vacuolated, and the mitochondrial cristae collapsed. In addition, it could be seen that bacteria were attached to the mucosa surface. The expression of IL-6, NF-κB and ICAM-1 in patients with obstructive jaundice was increased significantly compared with controls （IL-6： 0.18 ± 0.02, vs 0.13 ± 0.01, P 0.05; NF-κB： 0.23 ± 0.01 vs 0.19 ± 0.03, P 0.05; ICAM-1： 0.17 ± 0.01 vs 0.13 ± 0.02, P 0.05）.CONCLUSION： Intestinal mucosal injury in patients with obstructive jaundice is associated with high expression of IL-6, NF-κB and ICAM-1.