痰瘀蕴结型股骨头坏死脂代谢异常的信号转导途径研究

Investigation of Signal Transduction Pathway of Abnormal Lipid Metabolism in Phlegm-stasis Accumulation Type Femoral Head Necrosis

【目的】分析痰瘀蕴结型股骨头坏死脂代谢异常进行的信号转导途径,明确其发病机制,为更好地防治痰瘀蕴结型股骨头坏死以及从基因水平探讨新的治疗方法提供科学依据。【方法】收集在广州中医药大学第一附属医院行全髋关节置换的痰瘀蕴结型股骨头坏死病例23例(实验组),髋骨关节炎病例21例(对照组),采用实时荧光定量PCR法检测PPARγmRNA、LXRαmRNA、SREBP-1c mRNA在2组病例骨组织、肌肉组织中的表达情况。【结果】PPARγmRNA的表达量在骨组织中较肌肉组织中显著增多(P<0.05);PPARγmRNA的表达量在实验组中比LXRαmRNA和SREBP-1c mRNA显著增多(P<0.05),LXRαmRNA和SREBP-1c mRNA在实验组与对照组之间的表达量无显著差异(P>0.05)。【结论】PPARγ信号转导途径是痰瘀蕴结型股骨头坏死脂代谢异常进行的主要信号转导途径,酒精可能会上调PPARγmRNA的表达,进而导致脂代谢异常的发生,最终导致股骨头坏死。

Objective The abnormal lipid metabolism and its signal transduction pathway of phlegm-stasis accumulation type femoral head necrosis were analyzed to clarify its pathogenesis, thus to find better preventive and therapeutic methods for the phlegm-stasis accumulation type femoral head necrosis at the genetic level. Methods The study was carried out in 23 patients with phlegm-stasis accumulation type alcoholic femoral head necrosis and having taken total hip arthroplasty （experimental group）, and in 21 cases of hip arthritis （control group） . All of the patients were collected in the First Affiliated Hospital of Guangzhou University of Chinese Medicine. Real-time fluorescent quantitation polymerase chain reaction（PCR） was used to detect the expression of peroxisome proliferator-activated receptor gamma （PPARγ） mRNA, LXRot mRNA, SREBP-lc mRNA in the bone tissue and muscle tissue of both groups. Results The PPARγ mRNA expression level was significantly increased in the bone tissue as compared to that in the muscle tissue （P〈0.05）, and was higher than LXRα mRNA expression levels and SREBP-lc mRNA in the experimental group （P〈0.05）. There was no significant difference of the LXRα mRNA and SREBP-lc mRNA expression levels between experimental group and control group （P〉0.05）. Conclusion PPARγ signal transduction pathway is the main pathway which is contributed to the abnormal lipid metabolism in femoral head necrosis patients with phlegm-stasis accumulation type. The alcohol may increase the expression level of PPARγ mRNA, which induces the occurrence of abnormal lipid metabolism, and eventually results in femoral head necrosis.