心脏瓣膜间质细胞的表型转化及其与瓣膜病理形态发生的关系

The relationship between phenotypic regulation of the rheumatic heart valve interstitial population and pathological formation

目的 :研究风湿性心脏病瓣膜间质细胞的表型转化规律 ,探讨其与瓣膜病理形态发生的关系。方法 :手术切除风湿性心脏瓣膜系列组织标本 75例 ,依据大体病理形态进行分类 ,通过免疫组织化学方法进行瓣膜组织中间质细胞表达增殖细胞核抗原 ( PCNA )、α平滑肌肌动蛋白 (α SMA )和α1 ( )型前胶原蛋白 ( PCα1 )检测。结果 :PCNA蛋白表达主要集中在 、 型瓣膜组织中 , 型及正常人瓣膜组织间质细胞内呈弱表达或无表达 ;正常人及 型瓣膜组织有少量α SMA阳性细胞表达 , 、 型瓣膜组织中α SMA阳性细胞表达逐渐增加 ;PCα1 表达随病理形态发展逐渐增加 ,在 型病变组织中最高。结论 :心脏瓣膜间质细胞在不同时期分别向增殖表型、合成表型或收缩表型转化 。

Objective:To investigate the relationship between the phenotypic regulation of the rheumatic heart valve interstitial population and the biological mechanism of pathological formation.Methods:A series of human heart valve tissues of 75 patients with rheumatic heart disease was obtained during surgical intervention and was classified to typeⅠ,Ⅱ,Ⅲ according to its gross features,the expression of proliferating cell nuclear antigen(PCNA),α 1(Ⅰ) procollagen(PCα 1Ⅰ) and αsmooth muscle actin(αSMA) were determined using immunohistochemical techniques.Results:PCNA was present largely in both type Ⅰ and type Ⅱ and little or absent in type Ⅲ or normal heart valves.αSMA was present little in both normal heart valves and type Ⅰ and increased in type Ⅱ and type Ⅲ,the expression of PCα 1Ⅰ increased as the development of valve pathological morphology and was present heavily in type Ⅲ.Conclusions:The human heart valve interstitial population undertake the phenotypic properties of proliferation,synthesis of collagen and contraction,which may be central to the cellular mechanism of valvular pathological formation in rheumatic heart disease.