肥大细胞活化对非糜烂性反流病患者食管黏膜瞬时感受器电位香草酸受体1的影响

The effect of activation of mast cells on transient receptor potential vanilloid 1 in esophageal mucosa of patients with non-erosive reflux disease

目的观察非糜烂性反流病(non-erosive reflux disease,NERD)患者食管黏膜肥大细胞(mast cells,MCs)表达情况及与瞬时感受器电位香草酸受体1(transient receptor potential vanilloid 1,TRPV1)表达的相关性,以阐明MCs增殖活化对于NERD食管黏膜外周神经敏感受体的影响。方法通过HE染色、甲苯胺蓝染色、免疫组化、免疫荧光方法观察15例NERD患者及15名健康对照者MCs及TRPV1的表达。结果与健康对照组比较,NERD组患者食管黏膜微炎症表现:基底细胞增生、乳头肌延长、炎症细胞浸润、上皮细胞间隙增宽(DIS)更为明显;MCs数量增加(P<0.01);免疫组化肥大细胞类胰蛋白酶(mast cell tryptase,MCT)、TRPV1平均光密度值(MOD)增加(P<0.01);TRPV1的表达与MCs数量和MCT呈正相关(P<0.01);免疫荧光发现MCT与TRPV1表达增加并出现共定位现象。结论NERD患者食管黏膜固有层MCs数量增加、TRPV1表达上调且两者呈正相关。提示MCs增殖活化影响了TRPV1的表达,可能参与了食管高敏感的发生。

Objective To observe the expression of mast cells(MCs)in esophageal mucosa of non-erosive reflux disease(NERD)patients and its correlation with TRPV1 expression,so as to clarify the effect of proliferation and activation of MCs on esophageal mucosal sensitive receptors in NERD.Methods HE staining,toluidine blue staining,immunohistochemistry and immunofluorescence were used to observe the effect of MCs and TRPV1 in 15 patients with NERD and 15 healthy controls.Results Compared to the healthy controls,the microinflammation of esophageal mucosa:basal cell proliferation,papillary muscle prolongation,inflammatory cell infiltration and dilated intercellular spaces(DIS)were more obvious in NERD group;the number of MCs increased(P<0.01);the mean optical density(MOD)of mast cell tryptase(MCT)and TRPV1 increased in NERD group(P<0.01);the expression of TRPV1 was positively correlated with the number of MCs and MCT(P<0.01);the expression of MCT and TRPV1 was increased and co-localization was observed.Conclusion The number of MCs and the expression of TRPV1 in patients’lamina propria of esophageal mucosa with NERD are increased,and there is a positive correlation between them.The activation of MCs affects the expression of TRPV1 and participates in the development of esophageal hypersensitivity.