炎症体在皮肌炎与多发性肌炎肌肉组织中的表达

Expression of inflammasomes in muscle of dermatomyositis and polymyositis patients

目的:研究炎症体在皮肌炎(DM)和多发性肌炎(PM)受累肌肉中的表达情况,探讨其在发病机制中的意义。方法:采用免疫组织化学的方法检测新发病并未经治疗的成年DM/PM患者肌肉标本10例(DM 4例,PM 6例)及5例健康对照肌肉组织NALP1、NALP3、衔接蛋白ASC及半胱天冬酶-1(caspase-1)的表达情况。结果:4例DM患者肌肉组织中CD3+T细胞及CD20+B细胞均表达ASC及caspase-1,其中2例表达NALP3。6例PM患者中仅1例肌肉组织中CD3+T细胞及CD20+B细胞表达NALP3、ASC及caspase-1。10例患者均不表达NALP1。5例正常对照肌肉组织均不表达NALP1、NALP3、ASC及caspase-1。DM组ASC及caspase-1的表达阳性率显著高于PM组及正常对照组(P<0.01,P<0.05),NALP3的表达阳性率亦高于PM组及正常对照组,但均无统计学意义(均P>0.05)。结论:固有免疫反应与调节在DM和PM中起不同的作用。炎症体可能参与DM的发病过程,部分由NALP3激活。而炎症体激活可能并不参与大部分PM的发病。

Abstract Objective：To investigate the expression of inflammasomes in muscle of dermatomyositis（DM）and polymyositis （PM）patients.Methods ： Immunohistochemistry was performed to determine the expression of NALP1,NALP3,apoptosis-associated speck-like protein containing a CARD（ASC）and caspase-1 in muscle of 10 newly diagnosed and untreated adult DM/PM patients （4 DM and 6 PM）and 5 healthy controls.Results：In muscle of 4 DM patients,ASC and caspase-1 were expressed in the plasma of CD3＋ T and CD20＋ B cells, while in 2 of them NALP3 was also expressed.Only 1 PM patient in 6 expressed NALP3,ASC and caspase-1 in the plasma of CD3＋ T and CD20＋ B cells.NALP1 was not expressed in all of the 10 patients.No NALP1, NALP3,ASC and easpase-1 were expressed in the muscle of 5 healthy controls.The positive rate of ASC and caspase-1 in DM group was significantly higher than that in PM and control group（P〈0.01 ,P〈0.05）,while the positive rate of NALP3 in DM group was higher than that in PM and control group but with no statistical significance （both P〉0.05）.Conclusion：Innate immune may play different role in the pathogenesis of DM and PM.Inflammasome may participate in the inflammation of DM and be activated by NALP3 mostly,while it may not participate in the pathogenesis of most of PM.