垂体腺苷酸环化酶激活肽蛋白与慢性鼻-鼻窦炎和鼻息肉发病和预后的相关研究

The role of PACAP protein in chronic sinusitis with or without nasal polyps

目的:采用免疫组织化学实验并扩大标本量与临床疗效相结合观察垂体腺苷酸环化酶激活肽(PACAP)蛋白在慢性鼻-鼻窦炎、鼻息肉、难治性慢性鼻-鼻窦炎及正常鼻黏膜组织中的表达情况,了解PACAP蛋白与慢性鼻-鼻窦炎和鼻息肉发病、转归及预后的关系。方法:采用免疫组织化学SP法分别检测53例鼻息肉、70例慢性鼻-鼻窦炎、28例难治性慢性鼻-鼻窦炎病变组织和20例正常鼻黏膜组织石蜡标本的PACAP蛋白表达情况。结果:1PACAP蛋白表达于鼻黏膜上皮、腺上皮和杯状细胞的胞质和胞核中;2鼻息肉、慢性鼻-鼻窦炎、难治性慢性鼻-鼻窦炎和正常鼻黏膜组织之间PACAP蛋白阳性强度构成比差异有统计学意义(χ2=140.902,P<0.01)。鼻息肉组织的阳性强度以"+"为主,慢性鼻-鼻窦炎组织的阳性强度以"+++"为主,难治性慢性鼻-鼻窦炎组织的阳性强度以"-^+"为主,正常鼻黏膜组织的阳性强度以"++"为主。结论:PACAP蛋白是机体保护性蛋白,当鼻黏膜受病原体侵袭或理化因素刺激引起炎症反应时,鼻黏膜上皮、腺上皮和杯状细胞,尤其是腺体反应性增生明显,它们产生和分泌PACAP蛋白等抗炎物质增多从而起到炎症防御作用。当PACAP减少后,对鼻黏膜的抗炎及免疫调节作用下降,因此炎症易迁延不愈或致息肉复发。

Objective：To investigate the expression of PACAP protein in chronic rhinosinusitis without/with nasal polyps and refractory chronic rhinosinusitis.Method：Fifty-three patients with nasal polyps,70 cases with chronic sinusitis,28 patients with refractory chronic rhinosinusitis and 20 control cases were enrolled for this study.The expression of PACAP protein was detected by immunochemistry.Result：1PACAP protein were expressed in nasal epithelium,glandular epithelium and goblet cells;2The positive intensity of PACAP was ＂ ＋＂,＂ ＋ ＋＋＂,＂--＋＂,and ＂ ＋＋＂ in nasal polyps,chronic rhinosinusitis,refractory chronic rhinosinusitis,and control group,respectively.Conclusion：PACAP protein mainly locates in nasal epithelium,glandular epithelium and goblet cells.Reduced expression of PACAP may be related with onset of chronic rhiniosinusitis without/with nasal polyps.