中老年帕金森病患者外周血腺苷2A受体研究

Adenosine 2A receptors in peripheral blood of middle-aged and older Parkinson＇s disease patients

目的探讨外周血淋巴细胞腺苷2A（A2A）受体表达与帕金森病（PD）的相关性。方法回顾性研究，收集北京医院门诊PD患者（PD组）42例和健康对照者（对照组）32例，用流式细胞方法检验外周血淋巴细胞A2A受体表达水平，用酶联免疫吸附（ELISA）法检验血浆中游离A2A受体的浓度。比较PD组及对照组外周血淋巴细胞A2A受体表达、血浆游离A2A受体浓度等方面的差异。并对PD组的性别、年龄、病程、所用药物类型和剂量、运动并发症及PD评定量表（UPDRS）评分等与A2A受体表达水平进行多元回归分析及单因素相关分析。结果PD患者外周血淋巴细胞A2A受体表达水平（8．96±4．73）％高于对照组（5．39±2．42）％（t=4．210，P〈0．05）。而PD组患者外周血浆游离A2A受体浓度（1．82±1．91μg／L与对照组（1．15±0．71）μg／L比较，差异无统计学意义（t=1．078，P〉0．05）。PD组患者中有运动并发症的外周血淋巴细胞A2A受体表达水平低于无运动并发症患者（P〈0．05）。病程5～9年组患者外周血淋巴细胞A2A受体表达水平低于病程〈5年组（Z=-2．780，P〈0．01）和病程≥10年组（Z=-2．149，P〈0．05）。结论外周血淋巴细胞A2A受体表达水平与PD相关，PD患者外周血淋巴细胞A2A受体的表达随运动并发症发生和病程进展有波动，在疾病进展过程中其作为生物学标记的可能性需进一步验证。

Objective To investigate the expression level of adenosine 2A receptors in peripheral blood lymphocytes and the correlation with disease progression of Parkinson＇s disease （PD）. Methods In this retrospective study, out patients with PD（42 cases）and healthy controls（32 cases） were recruited at Beijing Hospital. The expression level of A2A receptors in peripheral blood lymphocytes was detected by flow cytometry. The concentration of free A2 A receptors in plasma was detected by enzyme-linked immunosorbent assay （ELISA）. The expression of A2A receptors and plasma free A2A receptors in peripheral blood lymphocytes of the PD group and the control group was compared. Multivariate regression analysis and single factor correlation analysis were performed on sex, age, course of disease, duration of medication, drug type and dose, motor complications, and PD unified Parkinson＇s disease rating scale （UPDRS）score. Results A2A receptor expression in lymphocytes was significantly higher in the PD group than in the control group （8.96 ± 4.73 ） % vs. （5. 39± 2. 42）% （t = 4. 210, P〈 0.05 ）. There was no significant difference in A2A receptor concentrations in plasma between the two groups （ 1.82 ±1. 91 ）μg/L vs. （ 1. 15 ±0. 71 ）μg/L （ t = 1. 078, P〉0. 05）. In the PD group, A2A receptor expression in lymphocytes in patients with motor complications was statistically lower than in patients without them （P〈 0.05 ）. Lymphocyte A2A receptor levels in the 5-9 years duration subgroup were significantly lower than those in the 〈 5 years duration subgroup （ Z= - 2.780, P〈 0.01 ） and the ≥ 10 years duration subgroup （ Z=- 2.149, P 〈0.05）. Conclusions The expression of A2A receptors in peripheral blood lymphocytes is correlated with PD. The expression of A2A receptors in peripheral blood lymphocytes of patients with PD flu＇ctuates with the occurrence of motor complications and the progression of disease. Further research is needed to establish A2A receptors as a biomarker for monitoring disease progression.