应用蛋白质组学技术筛选抽动障碍患儿不同中医证型血清相关蛋白

Screening of serum related proteins of different TCM syndromes with tic disorders by proteomic techniques

目的探究抽动障碍(TD)患儿血清差异表达蛋白,筛选不同中医证型TD患儿血清特异性差异表达蛋白。方法收集2017年4至9月西安市儿童医院儿保科门诊TD患儿60例(TD组,气郁化火证34例、脾虚痰聚证26例)及健康儿童30例(健康对照组),分离血清,应用磁珠分离及质谱技术,检测血清表达蛋白峰值,并对差异蛋白峰进行分析。结果 TD组与健康对照组儿童性别、年龄比较差异无统计学意义(χ~2=1.142,t=0.112,均P<0.05)。TD组与健康对照组间差异蛋白峰8个,其相对分子质量分别为1 869.76、6 443.34、6 642.05、863.13、2 175.98、2 191.84、2 277.19、2 293.11,差异均有统计学意义(均P<0.001);ROC曲线下面积分别为0.793、0.831、0.861、0.779、0.778、0.783、0.781、0.754。气郁化火证与脾虚痰聚证患儿间显著差异蛋白峰2个,其相对分子质量分别为873.73、6 642.04,差异均有统计学意义(均P<0.001);ROC曲线下面积分别为0.823、0.746。结论TD患儿组与健康对照组血清蛋白表达存在差异,这些差异可能有助于进一步探索儿童TD发病机制,或作为临床诊断的生物学标记;气郁化火证与脾虚痰聚证血清蛋白表达存在差异,可能与各证型微观物质表达有关,对探讨中医证型的生物学基础及建立诊断模型具有一定指导意义。

Objective To explore the differential expression of serum proteins in children with tic disorders（TD）and to screen the serum-specific differentially expressed proteins of TD children with different TCM syndromes.Methods Totally 60 children with TD（including 34 cases of syndrome of qi depression transforming into fire and 26 cases of spleen deficiency leading to phlegm syndrome）and 30 healthy children were enrolled in this study from April to September in 2017.Serum was separated from blood and the protein peaks were detected by Mass spectrometry based on magnetic particle.Results There was no significant difference in sex and age between TD group and healthy control group（χ~2=1.142,t=0.112,both P 0.05）.There were 8 differentially expressed protein peaks between TD group and healthy control group,and their relative molecular mass（Mr）were 1 869.76,6 443.34,6 642.05,863.13,2 175.98,2 191.84,2 277.19 and 2 293.11 with significant difference（P0.001）.Their AUC values were 0.793,0.831,0.861,0.779,0.778,0.783,0.781 and 0.754.There were 2 differentially expressed protein peaks between cases of syndrome of qi depression transforming into fire and cases of spleen deficiency leading to phlegm syndrome,and their relative molecular mass（Mr）were 873.73 and 6 642.04 with statistical significance（P0.001）.Their AUC values were 0.823 and0.766.Conclusion There are differences in serum protein expressions between TD children and healthy controls.These differences may be helpful to further explore the pathogenesis of childhood TD or serve as biomarkers for clinical diagnosis.The differences between syndrome of qi depression transforming into fire and spleen deficiency leading to phlegm syndrome may be related to the micro-material of syndromes.It is of guiding significance to explore the biological basis of TCM syndrome and to establish diagnostic models.