急性主动脉夹层患者补体活化及补体C3a受体表达的临床意义

The activation of complement system and expression of C3a receptor in human acute aortic dissection

目的:揭示急性主动脉夹层发生中,是否存在补体系统活化及补体活化产物C3a受体的表达变化。方法:收集2015年1月至2015年7月,在北京安贞医院接受体检的正常人、腹主动脉瘤手术以及急性主动脉夹层手术患者血液各5例,进行微量样本多指标流式蛋白定量试验,测定其补体系统活化产物过敏毒素C3a、C4a和C5a的水平;收集2015年1月至2015年7月,在北京安贞医院接受主动脉弓部替换术患者的升主动脉组织5例及心脏移植供受体正常的升主动脉组织5例,进行免疫组化组织染色,并提取蛋白,检测C3a受体的表达。结果:微量样本多指标流式蛋白定量试验结果显示,腹主动脉瘤和急性主动脉夹层患者血浆中补体活化产物C3a、C4a和C5a含量显著高于正常对照组(P<0.01),这说明补体活化不仅在腹主动脉瘤,急性主动夹层患者循环系统也存在。免疫印迹结果显示急性主动脉夹层患者标本中C3a受体蛋白表达量显著高于正常对照组(P<0.05)。免疫组化染色发现,与正常升主动脉壁相比较,急性主动脉夹层标本的C3a受体表达显著增高(P<0.01)。结论:急性主动脉夹层患者体内存在补体系统活化C3a-C3a受体信号通路,可能参与主动脉夹层的发生发展。

Objective： This study aimed to evaluate the activation of complement system and expression of complement activation product C3 a receptor（ C3aR） in the pathogenesis of acute aortic disseciton.Methods： Blood samples were collected respectively from normal persons who accepted health examination,patients with abodominal aortic aneurysm and patients with acute aortic dissection in Beijing Anzhen Hospital from Jan. 2015 to Jul. 2015. The plasma levels of complement system activation products—anaphylotoxin C3 a,C4a and C5 a were measured by human anaphylatoxin cytometric bead array CBA kit; ascending aortic wall tissues were collected separately from 5 patients who were undergone ascending aorta replacement surgery while the normal ascending aortic tissues from 5 donors＇ hearts during heart transplantation in Beijing Anzhen Hospital. The expression of C3 aR in aortic dissection tissue was analyzed by immunoblotting and immunohistochemistry staining. Results： The plasma levels of complement C3 a,C4a and C5 a in patients of abdominal aortic aneurysm and acute aortic dissection were significantly higher than those in the control group,suggesting complement acti-vation in patients with acute aortic dissection was also present. The protein expression of C3 aR and C3 aR positive area in the acute aortic dissection tissues were remarkably increased than those in the control aortas,implying that the expressions of C3 aR increased significantly in the acute aortic dissection tissues. Conclusion：Complement system is activated in patients with acute aortic dissection and the expression of C3 aR is increased significantly in acute aortic dissection tissues,which indicated C3a-C3 aR signaling might participate in the occurrence and development of acute aortic dissection.