肝泡型包虫病肝组织和血清中巨噬细胞极化特点及临床意义

Characteristics and clinical value of macrophage polarization in tissues and serum of patients with hepatic alveolar echinocococosis

目的探讨肝泡型包虫病肝组织和血清中巨噬细胞极化特点及临床意义。方法收集2017年1月至2019年2月30例肝泡型包虫病患者的肝组织标本和血液标本,均来自于青海大学附属医院手术室,将肝脏标本分为病灶邻近(PL)组织和正常(N)肝脏组织,进行HE染色,并进行Child-Pugh肝功能分型;采用免疫组化法检测CD86、CD11c和CD206阳性表达状态。另外收集30例健康人群地血液样本,采用ELISA法检测血清白细胞介素-6(IL-6)、IL-10、肿瘤坏死因子-α(TNF-α)、转化生长因子β1(TGF-β1)水平,另外采用Pearson相关性分析M2/M1比值与肝功能指标的关系。结果经HE染色,PL肝组织中有大量炎症细胞浸润,且CD86^+巨噬细胞和CD206^+ M2型巨噬细胞阳性表达率和阳性细胞百分比/视野明显高于N肝组织(P <0.05);但PL肝组织和N肝组织中CD11c^+ M1型巨噬细胞阳性表达率和阳性细胞百分比/视野比较差异无统计学意义(P> 0.05)。肝泡型包虫病PL肝组织中M2/M1比值(3.98±0.76)明显高于N肝组织(1.09±0.12),差异有统计学意义(P <0.05)。并且M2/M1比值与患者谷丙转氨酶水平呈正相关性,与白蛋白水平呈负相关(P <0.05),且随着Child-Pugh肝功能分级升高,M2/M1比值增加。另外,肝泡型包虫病患者血清IL-6、TNF-ɑ和TGF-β1水平明显高于健康人群(P <0.05)。结论肝泡型包虫病患者病灶邻近肝组织中存在大量CD86^+巨噬细胞浸润,且以CD206^+ M2型巨噬细胞为主,M2/M1比值与患者肝功能有关。

Objective To detect the characteristics and clinical value of macrophage polarization in tissues and serum of patients with hepatic alveolar echinocococosis(HAE).Methods The hepatic tissues(including paralesion tissues and normal hepatic tissues)and blood specimens were taken from 30 HAE patients from January 2017 to February 2019. Immunohistochemistry method was used to detected the positive expressions of CD86,CD11 c and CD206 in para-lesion(PL)tissues and normal(N)hepatic tissues. The plasma samples from 30 healthy volunteers were collected. The interleukin-6(IL-6),IL-10,tumor necrosis factor α(TNF-α)and transforming growth factor-β1(TGF-β1)levels were detected by ELISA assay. Pearson analysis was used to analyze the relationship between M2/M1 ratio and liver function indexes.Results HE staining results showed that there were amount of inflammatory cells infiltration in PL tissues. The positive expression rate and positive cells ratio of CD86^+ macrophages and CD206^+ M2 macrophages in PL tissues were higher than that in N tissues(P < 0.05),while there was no difference of CD11c^+ M1 macrophages between PL tissues and N tissues(P > 0.05). M2/M1 ratio in PL tissues was higher than that in N tissues[(3.98 ± 0.76)vs.(1.09 ± 0.12),P < 0.05],which was positively related with ALT and negatively related with ALB(P < 0.05). And also M2/M1 ratio was up-regulated with Child-Pugh classification increasing.Besides,the IL-6,TNF-α and TGF-β1 levels in HAE patients were higher than those in healthy volunteers(P < 0.05).Conclusions There is more CD86^+ macrophages infiltrated in para-lesion hepatic tissue,mainly CD206^+ M2 macrophages in HAE patients,and M2/M1 ratio was related with liver function of hepatic alveolar echinococcosis patients.