单核细胞趋化蛋白1mRNA在颅内动脉瘤瘤壁内的表达

Monocyte chemoattractant protein-1 mRNA in human intracranial aneurysm walls

目的 探讨脑动脉瘤发生发展的病理过程。 方法 对 2例未破裂的颅内动脉瘤和 11例破裂的颅内动脉瘤瘤壁组织进行常规HE染色和原位杂交的方法 ,观察单核细胞趋化蛋白 1(MCP 1)的mRNA在瘤壁内表达的位置 ;1例正常脑动脉壁组织做对照。 结果 2例未破裂和 10例破裂动脉瘤壁组织HE染色 ,显示瘤壁仅由增厚的内膜和结缔组织外膜组成。纤维增厚的内膜有长梭形的成纤维细胞不规则排列。瘤壁全层有单核细胞浸润。 1例破裂动脉瘤瘤壁仅存玻璃样变纤维结构 ,几乎不存在细胞成分。 1例未破裂动脉瘤和 8例破裂动脉瘤瘤壁有附壁血栓 ,血栓呈机化表现。原位杂交结果显示 :正常动脉未见杂交信号。 2例未破裂和 10例破裂动脉瘤瘤壁内有杂交阳性细胞 ,多为成纤维细胞 ,颗粒沉积于细胞质。单核细胞胞质少 ,阳性颗粒不明显。杂交阳性信号间断分布在动脉瘤瘤壁内膜 ,多出现于排列紊乱的成纤维细胞 ,淋巴细胞聚集处。 1例破裂动脉瘤瘤壁仅存玻璃样纤维结构 ,几乎不存在细胞 ,未见杂交信号。动脉瘤附壁血栓内MCP 1mRNA表达细胞有成纤维细胞、浆细胞、微血管的内皮细胞 ,表达部位在细胞质。 结论 未破裂的和破裂的动脉瘤瘤壁的病理表现和MCP 1mRNA的高表达 ,提示脑动脉瘤的发展是单核细胞为主的不断加强的慢性炎性过程。

Objective To investigate the pathological course in intracranial aneurysms. Methods Normal intracranial artery tissue (cortex fistulization) from 1 case, ruptured aneurysms tissuses from 11 cases, unruptured aneurysm tissues from 2 cases were obtained by neurosurgical excision. Routine HE staining was used to observe histological characteristics. In situ hybridization was used to observe the expression of the monocyte chemoattractant protein 1(MCP 1) mRNA in the walls of the normal artery and aneurysms. Results By the HE staining showed that the wall of the ruptured aneurysms(10 cases) and unruptured ones (2 cases) had increased intima and connectivum extima. The fibroblast in the intima was arrayed in the disorder. Monocyte like cells can be seen in the whole aneurysm wall. In one case aneurysms wall(ruptured) glass like fiber structure was left over, few cells could be seen. In 9 cases, mural thrombus was found. The thrombus represented with organization. In situ hybridization, MCP 1 mRNA was not detectable in the normal artery. The hybridization signal could be observed in the ruptured aneurysms (10 cases) and unruptured ones (2 cases) often in the intima. MCP 1 mRNA appeared to be expressed by fibroblast cells in its cytoplasm. Monocyte like cells had little cytoplasm, and the signal was seldom seen. The hybridization signal was discontinuous in the intima, MCP 1 mRNA expressed where fibroblast and monocyte like cells assembled. One ruptured aneurysm had no signal because there were no cells only glass like fiber. Mural thrombus showed upregulated hybridization signal in the cytoplasm of fibroblasts, phlogocytes and endotheliocytes of its micrangium. Conclusion The pathological representation of the ruptured and unruptured aneurysms and the upregulated expresion of MCP 1 in the aneurysm wall suggest that the development of aneurysm may be a course of chronic inflammation in which main inflammatory cells are monocyte like cells.