糖尿病性白内障晶状体上皮细胞凋亡及P53、Bcl-2的表达分析

Apoptosis of lens epithelial cells and expression of P53 and Bcl-2 in diabetic cataract

目的探讨细胞凋亡与糖尿病性白内障的关系。方法选取2016年1-6月重庆医科大学附属第二医院收治的白内障住院患者59例,施行超声乳化白内障手术治疗获得晶状体前囊膜。根据临床诊断将24例糖尿病性白内障患者前囊标本设为研究组(Ⅰ组),35例无糖尿病的年龄相关性白内障患者前囊标本设为阳性对照组(Ⅱ组),另将11例无白内障的眼创伤患者晶状体摘除前囊膜及意外死亡者囊膜标本设为阴性对照组(Ⅲ组)。采用原位细胞凋亡检测观察晶状体前囊上皮凋亡发生率,免疫组织化学检测晶体上皮细胞肿瘤抑制蛋白(P53)、原癌基因蛋白(Bcl-2)表达阳性率。结果Ⅰ组患者晶状体上皮细胞凋亡发生率、P53蛋白表达阳性率均明显高于Ⅱ、Ⅲ组,Bcl-2蛋白表达阳性率均明显低于Ⅱ、Ⅲ组,差异均有统计学意义(P<0.05)。结论糖尿病患者晶状体上皮细胞凋亡蛋白P53表达水平升高,Bcl-2蛋白表达降低,诱发了晶状体上皮细胞凋亡,可能是糖尿病白内障的主要发病因素。

Objective To explore the relationship between apoptosis and diabetic cataract. Methods From January 2016 to June 2016,59 patients with cataract in the Second Affiliated Hospital of Chongqing Medical University were selected and were performed with phacoemulsification surgery to obtain the anterior capsular membrane.According to clinical diagnosis,24 anterior capsule specimens of diabetic cataract patients were set as study group (Ⅰ group),35 age-related cataract patients without diabetes were set as positive control group (Ⅱ group),and 11 cases of cataract-free eye trauma patients with anterior capsule extraction and accidental death of capsule specimens were set as negative control group (Ⅲ group).The apoptotic rate of anterior capsular epithelium was observed by TUNEL method,and the expression of P53 and Bcl-2 protein in lens epithelial cells was observed by immuno- histochemistry. Results The incidence of lens epithelial cell apoptosis and the positive rate of P53 protein in Ⅰ group were significantly higher than those in Ⅱ group and Ⅲ group,while the expression of Bcl-2 protein was lower and the differences were statistically significant ( P <0.05). Conclusion The expression of apoptotic protein P53 in lens epithelium of diabetic patients increased,while the expression of Bcl-2 protein decreased,which induced the apoptosis of lens epithelial cells,which may be the main pathogenic factor of diabetic cataract.