选择素-P及可溶性粘附分子SVCAM-1在妊娠肝内胆汁淤积症患者中的变化及意义

The changes of P-selectin and SVCAM-1 in intrahepatic cholestasis of pregnancy(ICP) .

目的 探讨选择素 -P(P -selectin)在妊娠肝内胆汁淤积症 (ICP)患者 ,脐带血管内皮细胞上的表达及干扰素 (IFN -γ)、地塞米松 (DEX)对其表达的影响 ;了解可溶性粘附分子血管细胞粘附分子 - 1(SVCAM - 1)在ICP母血、脐血的变化。方法 采用脐带内皮细胞培养 ,流式细胞仪检测P -selectin的表达 ;采用ELISA的方法了解SVCAM - 1的变化。结果 在未加干扰素时 ,ICP患者脐带内皮细胞P -selectin的表达均较正常妊娠妇女高 (P <0 0 1) ;经IFN -γ刺激后 ,随着IFN -γ质量浓度的增加 ,正常组和ICP组P -selectin的表达逐渐增强(P <0 0 5 ) ;地塞米松可以抑制IFN -γ对胎儿脐带内皮细胞P -selectin的上调作用 (P <0 0 5 ) ;ICP患者血清、脐血中SVCAM - 1的浓度明显高于正常孕妇组 (P <0 0 1) ;两组孕妇产后一周母血SVCAM - 1逐渐降至正常 (P >0 0 5 )。结论 ICP患者粘附分子表达的异常可能是ICP发病机制的一个重要环节 。

Objective 1.To explore the expression of P-selectin in the endothelial cells of umbilical cord and the effects of IFN-γ and Dexamethasone(DEX) on its expression in ICP;2.To investigate circulating levels of vascular cell adhesion molecule-1 in the peripheral and uteroplacental circulations of ICP.Methods HUVEC was cultured and stimulated with IFN-γ and DEX.The expression of P-selectin was measured by Flow Cytometry;ELISIA was employed in detecting the change of SVCAM-1.Results The expression of P-selectin on the HUVEC without any stimulation in the women with ICP was significantly higher than that of the normal pregnancy(P<0 01).The expression of P-selectin on the HUVEC was higher after stimulation with IFN-γ than that of without stimulation in the women with ICP and so did the women with normal pregnancy(P<0 05).There was close correspondent changes among the expression of P-selectin on the HUVEC and the concentration action of IFN-γ (P<0 05).Dexamethasone(DEX) significantly attenuated expression of P-selectin on HUREC which were induced by IFN-γ(P<0 05).The expression of P-selectin on HUREC were closely correlated with the concentration action of DEX(P<0 05).Significantly higher level of SVCAM-1 was detected in the uteroplacental(P<0 01) and peripheral circulation of ICP women by comparison with normal pregnancy(P<0 05),and then it markedly decreased to normal one week after delivery.Conclusion Our research suggests that abnormal expression of adhesion molecules may play a role in the pathogenesis of ICP and DEX might be an effective drug in the treatment of it.