散发性主动脉猝死患者主动脉壁中膜层血管平滑肌细胞MYLK、MYH11、TGFβR2、MMP9的表达观察

Expression changes and significance of MYLK,MYH11,TGFβR2,and MMP-9 in vascular smooth muscle cells of aortic wall in patients with sporadic sudden aortic death

目的观察散发性主动脉猝死(SAD)患者主动脉壁中膜层血管平滑肌细胞(VSMC)肌球蛋白轻链激酶(MYLK)、肌球蛋白重链11(MYH11)、转化生长因子β受体2(TGFβR2)、基质金属蛋白酶9(MMP9)的表达变化,并探讨其临床意义。方法 27例散发性SAD患者的主动脉壁中膜层标本为SAD组,27例死因排除主动脉夹层(AD)猝死患者的主动脉壁中膜层标本为对照组。采用免疫组化法检测两组主动脉壁中膜层VSMC中MYLK、MYH11、TGFβR2、MMP9。结果 SAD组主动脉壁中膜层VSMC中MYLK、TGFβR2、MYH11、MMP9阳性表达率分别为25. 9%(7/27)、29. 6%(8/27)、18. 5%(5/27)、88. 9%(24/27),对照组分别为77. 8%(21/27)、74. 1%(20/27)、81. 5%(22/27)、29. 6%(8/27)。与对照组比较,SAD组主动脉壁中膜层VSMC中MYLK、TGFβR2、MYH11阳性表达率升高,MMP9阳性表达率降低(P均<0. 05)。结论散发性SAD患者主动脉壁中膜层VSMC中MYLK、MYH11、TGFβR2低表达,MMP9高表达。MYLK、MYH11、TGFβR2、MMP9表达变化可能与散发性SAD的发生、发展有关。

ObjectiveTo observe the expression of myosin light chain kinase(MYLK),myosin heavy chain 11(MYH11),transforming growth factorβreceptor 2(TGFβR2),and matrix metalloproteinase 9(MMP-9)in the vascular smooth muscle cells(VSMCs)of aortic wall in patients with sporadic sudden aortic death(SAD),and to explore their clinical significance.MethodsTwenty-seven cases of aortic wall intima-medial specimen taken from patients with sporadic SAD(SAD group)and other 27 cases from patients who did not die of aortic dissection(AD)(control group)were selected.Immunohistochemistry was used to detect the MYLK,MYH11,TGFβR2 and MMP-9 in VSMCs of aortic wall in the two groups.ResultsThe positive rates of MYLK,TGFβR2,MYH11,and MMP-9 in VSMCs of the SAD group were 25.9%(7/27),29.6%(8/27),18.5%(5/27),and 88.9%(24/27),respectively;the positive rates of MYLK,TGFβR2,MYH11,and MMP-9 in the VSMCs of the control group were 77.8%(21/27),74.1%(20/27),81.5%(22/27),and 29.6%(8/27),respectively.Compared with the control group,the positive rates of MYLK,TGFβR2,and MYH11 in the VSMCs of aortic wall in the SAD group increased,while the positive rate of MMP-9 decreased(all P<0.05).ConclusionsMYLK,MYH11,and TGFβR2 are lowly expressed and MMP-9 is highly expressed in VSMCs of aortic wall in sporadic SAD patients.The expression changes of MYLK,MYH11,TGFβR2,and MMP-9 may be related to the occurrence and development of sporadic SAD.