转化生长因子β和胶原蛋白mRNA在外阴硬化性苔藓病变中的表达意义

The role of transforming growth factor β1 and collagen in vulvar lichen sclerosis

目的目前在外阴硬化性苔藓(VLS)中关于转化生长因子β(TGF-β)及胶原蛋白Ⅰ、Ⅲ(Col Ⅰ、Ⅲ)mRNA表达的研究较少。文中旨在探讨TGF-β1、TGF-β2及Col Ⅰ、Ⅲ mRNA在VLS中的表达及临床意义。方法选取2016年9月至2018年6月中国医科大学附属第一医院妇科手术切除或活检的30份外阴硬化性苔藓标本。VLS早期和进展期各15份,外阴整形手术切除的正常皮肤标本15份。采用RT-PCR方法检测组织中TGF-β1、TGF-β2及Col Ⅰ、Col Ⅲ mRNA的表达,同时利用Vimentin标记检测病变组织中成纤维细胞的含量。结果VLS平均光密度值(129.3±59.78)较正常皮肤(47.04±5.311)明显增加(P<0.05)。早期VLS中Vimentin阳性细胞主要分布在真皮浅层,进展期VLS中Vimentin阳性细胞主要分布在真皮深层。早期VLS平均光密度值(136.9±43.02)与进展期VLS(127.9±19.41)差异无统计学意义(P>0.05)。VLS中TGF-β1 mRNA表达(110.68±56.34)较正常皮肤(1.72±1.00)明显增加(P<0.05)。VLS进展期TGF-β1 mRNA(104.31±57.29)明显高于VLS早期(6.37±3.03),差异有统计学意义(P<0.05)。VLS及VLS早期中Col Ⅰ mRNA表达量较正常皮肤明显增加(P<0.05)。VLS中Col Ⅰ/Ⅲ比值较正常皮肤明显增加(P<0.05)。结论VLS真皮层内成纤维细胞和TGF-β1增加,促进Col Ⅰ的合成,减少Col Ⅲ的含量,可能是导致VLS皮肤弹性减低的因素之一。

Objective To investigate the expression of transforming growth factorβ1(TGF-β1)and collagen Ⅰ、Ⅲ(Col Ⅰ、Ⅲ)in vulvar lichen sclerosis(VLS)and their role in VLS.Methods The specimens of30 VLS tissues(15 in early stage and 15 in progressive stage),and 15 vulvar normal skin tissues were selected by biopsy or surgical excision from 2016 to 2018 in our hospital.The expression of Vimentin was detected by immunohistochemistry.The expression of TGF-β1,TGF-β2,Col IⅠand Col Ⅲ mRNA was detected through RT-PCR.Simultaneously,the fibroblasts were visualized in diseased tissues by labeling Vimentin.Results The expression of Vimentin in VLS was increased significantly(P<0.05).The distribution of Vimentin-expressed cells was mostly in the superficial dermis in the early stage or deep dermis in the progressive stage of VLS.TGF-β1 mRNA was up-regulated in VLS(P<0.05),mainly in the progressive stage.TGF-β2 mRNA was increased slightly in the progressive stage of VLS,but there was no statistical difference(P>0.05).Col ⅠmRNA was up-regulated in VLS,obviously in early stage.Meanwhile,Col Ⅲ mRNA down-regulated gradually from the early to the progressive stage of VLS.Therefore,the Col Ⅰ/Ⅲratio increased gradually.Conclusion The increase of fibroblasts and TGF-β1 in dermis of VLS promotes the synthesis of Col Ⅰ and reduces the content of Col Ⅲ,which may be one of the factors leading to the decrease of skin elasticity in VLS.