免疫因子与间质性膀胱炎/膀胱疼痛综合征相关性研究

On Role of Immune Factors in Occurrence and Progression of Interstitial Cystitis/Bladder Pain Syndrome

目的探讨免疫因子在间质性膀胱炎/膀胱疼痛综合征发生与进展中的作用.方法选取间质性膀胱炎/膀胱疼痛综合征患者42例为观察组,同期行输尿管镜检查的18例患者正常膀胱组织为对照组.透射电子显微镜观察浆细胞和肥大细胞的表达;免疫组化法检测白细胞介素(IL)-2,IL-10,Siglec-15的表达水平;进行盆腔疼痛和尿频、尿急症状(PUF)评分,分析免疫因子表达与PUF评分的关系.结果观察组42例间质性膀胱炎/膀胱疼痛综合征患者中36例在透射电子显微镜下观察可见浆细胞和肥大细胞,其中肥大细胞出现脱颗粒状态26例;对照组膀胱黏膜组织中透射电子显微镜下未见浆细胞和肥大细胞.观察组患者膀胱黏膜组织中IL-2,IL-10呈弱阳性、强阳性表达的比例明显高于对照组,IL-2,IL-10呈阴性表达的比例明显低于对照组,差异具有统计学意义(P<0.01);膀胱黏膜组织中Siglec-15表达情况在两组间差异无统计学意义(P>0.05).观察组IL-2,IL-10强阳性患者的PUF评分明显高于弱阳性和阴性患者,差异具有统计学意义(P<0.01);Siglec-15阴性患者的PUF评分明显低于阳性和强阳性患者,差异具有统计学意义(P<0.01).结论间质性膀胱炎/膀胱疼痛综合征患者膀胱黏膜组织中存在浆细胞浸润、肥大细胞出现脱颗粒;IL-2,IL-10表达水平与症状程度呈正相关,Siglec-15表达水平与症状程度呈负相关.

Objective To investigate the role of immune factors in the occurrence and progression of interstitial cystitis/bladder pain syndrome.Method 42 patients with interstitial cystitis/bladder pain syndrome were selected as the observation group,while18 patients with normal bladder tissue underwent ureteroscopic examination during the same period were selected as the control group.The expression of plasma cells and mast cells were observed by transmission electron microscopy,the expression levels of interleukin (IL)-2,IL-10 and Siglec-15 were detected by immunohistochemistry,pelvic pain,frequency of urination and urinary emergencies (PUF) were scored,and the relationship between the expression of immune factors and PUF score was analyzed. Results In the observation group,36 cases of 42 patients with interstitial cystitis/bladder pain syndrome were observed under transmission electron microscopy ,of which26 cases had degranulation of mast cells,while in the control group,no plasma cells and mast cells were observed under transmission electron microscopy.The proportion of weak positive and strong positive expression of IL-2 and IL-10 in bladder mucosa of the observation group was significantly higher than that of the control group,and the proportion of negative expression of IL-2 and IL-10 was significantly lower than that of the control group ( P <0.01 );there was no significant difference in the expression of Siglec-15 in bladder mucosa between the two groups ( P >0.05 ).The PUF scores of the patients with strong positive IL-2 and IL-10 in the observation group were significantly higher than those of the patients with weak positive and negative IL-10 ( P <0.01);PUF scores of the patients with negative Siglec-15 were significantly lower than those of the patients with strong positive IL-2 and IL-10 ( P <0. 01). ConclusionThere are plasma cell infiltration and mast cell degranulation in bladder mucosa of patients with interstitial cystitis/bladder pain syndrome.The expression levels of IL-2 and IL-10 are positively correlated with the degree of symptoms,while the expression levels of Siglec-15 are negatively correlated with the degree of symptoms.