帕金森病患者结肠黏膜磷酸化α-突触核蛋白的检测及其临床意义

Detection of colonic mucosal phosphorylated α-synuclein in patients with Parkinson's disease and its clinical significance

目的:探讨磷酸化α-突触核蛋白(phosphorylatedα-synuclein,p SNCA)在帕金森病便秘(PD patients with constipation,PDC)患者结肠黏膜中的表达及其与非运动症状的关系。方法:将10例PDC患者及10例性别、年龄匹配的功能性便秘(func-tional constipation,FC)患者纳入研究,进行临床资料及非运动症状的评估。通过内镜活检获取每位受试者升、降结肠黏膜组织各2块,用免疫组织化学技术染色并评估p SNCA和神经元标志物-神经丝蛋白(NF)的表达,并进行共定位。最后进行p SNCA与非运动症状之间的相关性分析以探索非运动症状的发生机制。结果:所有PDC患者结肠黏膜均表达p SNCA(10/10),对照组阳性率90%(9/10),两组阳性率差异无统计学意义;但两组p SNCA的表达量差异有统计学意义(P<0.05),且PDC组更为显著;PDC患者的p SNCA表达量与H-Y分期存在相关性(r=-0.59,P<0.05),而与病程、UPDRSⅢ评分、LEDD无关,便秘严重程度与UPDRSⅢ评分存在相关性(r=0.67,P<0.05)。此外,患者非运动症状(包括焦虑、抑郁、睡眠障碍、疲劳、便秘)的严重程度与肠道p SNCA的沉积无关。结论:p SNCA的沉积可能参与便秘以及帕金森病的发生发展,但与帕金森病的非运动症状无关。

Objective：To investigate the expression of phosphorylated α-synuclein（p SNCA）in colonic mucosa of Parkinson＇sdisease（PD）patients with constipation and its relationship with non-motor symptoms. Methods：Ten constipated patients with PD（PDC）and 10 gender-and age-matched patients with functional constipation（FC）were enrolled in this study,and the clinical data andnon-motor symptoms were evaluated. Two specimens of ascending and descending colonic mucosa were obtained from each subject byendoscopic biopsy. p SNCA and neurofilament protein（NF）were stained by immunohistochemistry and colocalized. Finally,thecorrelation between p SNCA and non-motor symptoms was conducted to explore the mechanism of non-motor symptoms in PD. Results：All PDC patients displayed p SNCA（10/10）in the colonic mucosa and 90%（9/10）in the control group,with no significant differencebetween the two groups. However,there was a statistically significant difference between the two groups in the expression of p SNCA（P〈0.05）,and the PDC group was more significant. The level of p SNCA in PDC patients was related to H-Y stage（r=-0.59,P〈0.05）,butnot with disease duration,UPDRS-Ⅲ score and LEDD. The severity of constipation in PD was associated with UPDRS-Ⅲscore（r=0.67,P〈0.05）. In addition,the severity of non-motor symptoms（including anxiety,depression,sleep disturbances,fatigue,constipation）inpatients was not related to the deposition of p SNCA in the intestine. Conclusion：The deposition of p SNCA may be involved in thedevelopment of constipation and Parkinson＇s disease,but not corelate with the non-motor symptoms of Parkinson＇s disease.