嗜酸细胞性食管炎和胃食管反流病患儿聚丝蛋白和骨膜蛋白表达水平分析

Analysis of expressions of filaggrin and periostin in children with eosinophilic esophagitis and gastroesophageal reflux disease

目的评估嗜酸性粒细胞性食管炎(eosinophilic esophagitis,EOE)患儿食管组织样本中聚丝蛋白(filaggrin,FLG)和骨膜蛋白(periostin,POSTN)的免疫组织化学表达水平。方法选取2015年3月至2017年3月在延安大学附属医院接受治疗的患儿为受试对象,EOE患儿、胃食管反流病(gastroesophageal reflux disease,GERD)患儿及对照组儿童各16例。EOE组患儿接受饮食和/或药物(皮质类固醇)治疗,并对患儿和对照受试者开展活检、FLG和POSTN的免疫组织化学表达水平评估。结果对照组所有食管活组织检查均显示FLG染色阳性和POSTN染色阴性结果。相反,所有EOE患儿预治疗后活检时FLG和POSTN染色分别呈阴性和阳性,而GERD患儿中FLG和POSTN染色阳性比例分别为62.5%和87.5%(P<0.001)。在EOE组中,二次活检时,FLG阴性和POSTN阳性染色结果的病例比例相比首次活检显著降低,差异有统计学意义(P均<0.001)。结论活动性EOE患儿食管黏膜FLG和POSTN表达可能分别出现下调和上调,治疗后显著比例的受试者上述变化得到恢复。但仍需开展大型研究对该发现作进一步调查。

Objective To evaluate the immunohistochemical expression levels of filaggrin(FLG) and periostin(POSTN) in esophageal tissue samples from children with eosinophilic esophagitis(EOE) compared with children with gastroesophageal reflux disease(GERD) and control group. Methods Children who were treated in the Affiliated Hospital of Yan’an University from Mar. 2015 to Mar. 2017 were selected as subjects, 16 children with EOE, 16 children with GERD, and 16 children in control group, respectively. Children in EOE group received diet treatment and/or medication(corticosteroids). All subjects received biopsies as well as evaluation of immunohistochemical expressions of FLG and POSTN. Results All esophageal biopsies in control group showed positive FLG staining and negative POSTN staining. In contrast, after biopsy, all EOE children had negative FLG and positive POSTN staining. And the positive rates of FLG and POSTN staining in GERD cases were 62.5% and 87.5%, respectively(P<0.001). In EOE group, the proportions of children with FLG-negative and POSTN-positive staining were significantly lower at the second biopsy than those in the first biopsy, and the results were statistically significant(all P<0.001). Conclusion In the patients with active EOE, FLG expression was downregulated and POSTN expression was upregulated. And the above-mentioned changes were restored with a significant proportion in subjects received treatment. However, larger studies are still needed to investigate these findings further.