鼻用激素治疗鼻息肉对髓样细胞白血病1基因和半胱氨酸天冬氨酸蛋白酶3基因表达的影响

Impact of nasal hormone therapy for nasal polyps on expressions of myeloid cell leukemia 1 gene and cysteinyl aspartate specific proteinase 3 gene

目的探讨鼻用激素治疗鼻息肉的机制及对其髓样细胞白血病1(MCL-1)基因和半胱氨酸天冬氨酸酶蛋白-3(Caspase-3)基因表达的影响。方法选取35例鼻息肉患者作为观察组,均在接受丙酸氟替卡松鼻喷剂治疗14 d后行内镜下鼻息肉切除术治疗,分别留取治疗前后鼻息肉组织,将激素治疗前采集的鼻息肉组织作为单纯鼻息肉组,将激素联合手术切除术后采集的鼻息肉组织作为鼻息肉激素组;另选取35例同期单纯鼻中隔偏曲患者作为对照组,采集其正常的中鼻甲组织作为鼻腔黏膜组。3组标本均行常规苏木精-伊红(HE)染色和免疫组化染色。记录10个高倍视野中的嗜酸性粒细胞(EOS)数量,比较3组MCL-1、Caspase-3表达水平。结果单纯鼻息肉组、鼻息肉激素组的EOS数量均多于鼻腔黏膜组,且单纯鼻息肉组的EOS数量多于鼻息肉激素组(P<0.05)。单纯鼻息肉组、鼻息肉激素组和鼻腔黏膜组的MCL-1阳性率依次降低(均P<0.05);单纯鼻息肉组、鼻息肉激素组和鼻腔黏膜组的Caspase-3阳性率依次升高(均P<0.05)。单纯鼻息肉组和鼻息肉激素组的MCL-1表达与EOS浸润程度呈正相关,Caspase-3表达与EOS浸润程度呈负相关(P<0.05)。结论丙酸氟替卡松鼻喷雾剂作为经典的鼻用人工合成类固醇激素,可有效治疗鼻息肉,其作用机制可能与下调MCL-1表达和促进Caspase-3活化有关。

Objective To investigate the mechanism of nasal hormone in the treatment of nasal polyps and its effect on the expressions of myeloid cell leukemia 1（MCL-1） gene and cysteinyl aspartate specific proteinase 3（Caspase-3） gene. Methods Thirty-five patients with nasal polyps were selected as observation group and received endoscopic nasal polyp resection after 14 days of treatment with Fluticasone Propionate Nasal Spray. The specimens of nasal polyp tissues were collected respectively before and after treatment,including the specimens collected before the hormone treatment as simple nasal polyp group and the specimens collected after the hormone treatment combined with resection as nasal polyp-hormone group. Another 35 concurrent patients with simple nasal septum deviation were selected as control group,and their normal middle turbinate tissues were collected as nasal mucosa group. Routine hematoxylin-eosin staining and immunohistochemical staining were performed in the three groups. The number of eosinophils（EOS） in 10 high power fields was recorded,and the expression levels of MCL-1 and Caspase-3 were compared among the three groups. Results The number of EOS in the simple nasal polyp group and nasal polyp-hormone group was higher than that in the nasal mucous group,and the number in the simple nasal polyp group was more than that in the nasal polyp-hormone group（P〈0. 05）. The positive rates of MCL-1 in the simple nasal polyp group,nasal polyp-hormone group and nasal mucosa group decreased in turn（all P〈0. 05）. The positive rates of Caspase-3 in the simple nasal polyp group,nasal polyp-hormone group and nasal mucosa group increased in turn（all P〈0. 05）. In the simple nasal polyp group and nasal polyp-hormone group,the expression of MCL-1 positively correlated with the invasion depth of EOS,and the expression of Caspase-3 negatively correlated with the invasion depth of EOS（P〈0. 05）. Conclusion Fluticasone Propionate Nasal Spray,a classical synthetic steroid hormone,can achieve an significant efficacy for nasal polyps,which might be related to down-regulating MCL-1 expression and promoting Caspase-3 activation.