NLRP3在继发性甲状旁腺功能亢进症中的表达及临床意义

Expression of NLRP3 in secondary hyperparathyroidism and its clinical significance

目的:探讨NOD样受体家族蛋白3(NLRP3)炎性小体在慢性肾脏病继发性甲状旁腺功能亢进症(SHPT)中的表达及临床意义。方法:应用HE染色观察SHPT病人异常增生的甲状旁腺镜下形态;采用ELISA法检测正常人和SHPT病人血清中NLRP3水平;免疫组织化学SP法检测NLRP3在正常和异常增生的甲状旁腺组织中的表达,并分析NLRP3的表达与SHPT临床病理特征的关系。结果:SHPT病人异常增生的甲状旁腺镜下可表现为弥漫性及腺瘤样增生,与正常甲状旁腺表现明显不同;NLRP3在SHPT病人血清中的水平明显高于正常人(P<0.01);NLRP3在SHPT病人异常增生的甲状旁腺组织中的阳性率明显高于正常甲状旁腺组织(P<0.01)。不同性别、年龄、透析方式、透析龄等SHPT病人甲状旁腺组织中NLRP3蛋白表达差异均无统计学意义(P>0.05)。结论:NLRP3可能参与慢性肾脏病病人SHPT的发生、发展,其高表达有望成为SHPT早期诊断及预后评估的重要指标。

Objective:To investigate the expression and clinical significance of NOD-like receptor family pyrin domain containing 3(NLRP3)in secondary hyperparathyroidism(SHPT).Methods:HE staining was used to observe the difference of parathyroid gland in normal people and SHPT patients.ELISA was used to detect the serum level of NLRP3 in normal people and SHPT patients.Immunohistochemistry of SP method was used to detect the expression of NLRP3 in normal and hyperplastic parathyroid tissue,and the relationship between NLRP3 expression and SHPT clinical-pathological characteristics was analyzed.Results:Hyperplastic parathyroid glands in SHPT patients manifested as diffuse and adenoma-like hyperplasia,which was obviously different from that of normal,and the serum level of NLRP3 in SHPT patients was significantly higher than that of normal people(P<0.01).The positive rate of NLRP3 in abnormal hyperplastic parathyroid tissue in SHPT patients was significantly higher than that in normal parathyroid tissue(P<0.01).The expression of NLRP3 in SHPT patients had no correlation with gender,age,dialysis method or dialysis age(P>0.05).Conclusions:NLRP3 may be involved in the occurrence and development of SHPT,and its high expression is expected to become an important indicator for the early diagnosis and prognostic evaluation of SHPT.