退行性主动脉瓣脂肪因子chemerin的表达

Expression of Chemerin,an Adipokine,in the Degenerative Aortic Valve

目的观察脂肪因子chemerin在退行性主动脉瓣疾病(degenerative aortic valve disease,DAVD)瓣膜组织中的表达特点。方法收集2012年10月至2013年10月在海南省人民医院心脏外科因DAVD行手术切除的主动脉瓣标本30例,男17例,女13例,年龄(55±6)岁;夹层动脉瘤行Bentall手术切除正常三叶式主动脉瓣标本7例,男4例,女3例,年龄(41±8)岁。经苏木精-伊红(HE)染色观察退行性主动脉瓣的病理组织学改变;IHC染色观察脂肪因子chemerin的表达特点;IPP(Image-Pro Plus)软件测量钙化面积和钙化周围(钙化灶周围2mm区域)chemerin蛋白的累积光密度(integrated optical density,IOD),单元线性回归分析两者间的相关性。结果与正常瓣膜相比较,肉眼可见DAVD主动脉瓣增厚,存在不同程度的脂肪组织和钙化结节;HE染色可见DAVD损伤部位有泡沫细胞、脂肪细胞、炎症细胞、新生毛细血管和钙化灶。免疫组织化学(IHC)染色观察,脂肪因子chemerin在正常主动脉瓣膜无阳性表达,而在DAVD中阳性表达;单元线性回归分析表明chemerin蛋白的IOD与钙化面积呈正相关(r=0.985,P<0.05)。结论 DAVD瓣膜中脂肪因子chemerin阳性表达,chemerin表达强度与钙化面积呈正相关。

Objective To explore the expression of chemerin,a novel adipokine,in degenerative aortic valve disease （DAVD）.Methods Thirty specimens of the aortic valve were collected from patients who underwent surgical treatment for DAVD in the Department of Heart Surgery,Hainan Provincial People＇s Hospital from October 2012 to October 2013[male：17 cases,female：13 cases,average age：（55 ± 6） years].Normal aortic valve specimens were obtained from 7 patients who were diagnosed with dissecting aneurysm and underwent Bentall resection[males：4 cases,females：3 cases,average age：（41 ± 8） years].The pathological characteristics of degenerative aortic valves were measured by HE staining and the expression of chemerin were immunohistochemically observed（IHC staining）.IPP（Image-Pro Plus）software was used to detect the calcification area and the integrated optical density（IOD）of chemerin protein in the periphery of calcified nodules（2 mm adjacent to calcified nod ules）.Simple linear regression analysis was employed to analyze the relationship between the area of calcification and the IOD of chemerin protein.Results The degenerative aortic valves were significantly thickened as compared with the normal valves on the gross specimens.There were adipose tissues and calcified nodules in the degenerative aortic valves.HE staining showed foam cells,fat cells and inflammatory cells,angiogenesis,calcified nodules in the damaged area of the degenerative aortic valves.IHC staining revealed the positive expression of chemerin in the degenerative aortic valves and negative expression in the normal aortic valves.Simple linear regression analysis showed the IOD of chemerin was positively associated with the area of calcification（r =0.985,P〈0.05）.Conclusion Chemerin is expressed in the degenerative aortic valves in DAVD,and the chemerin expression is positively associated with the area of calcification.