胫骨平台骨折患者血浆lncRNA HAGLR表达与骨形成蛋白-2的关系

Correlation between plasma lncRNA HAGLR and bone morphogenetic protein-2 in patients with tibial plateau fractures

目的观察不同分型胫骨平台骨折患者手术前后血浆lncRNA HAGLR、骨形成蛋白-2(bone morphogenetic protein-2,BMP-2)表达变化,探讨骨折愈合中lncRNA HAGLR表达与BMP-2的关系。方法行手术治疗胫骨平台骨折患者80例,术前Schatzker分型Ⅰ型23例为Ⅰ型组,Ⅱ型45例为Ⅱ型组,Ⅲ型9例为Ⅲ型组,Ⅳ型3例为Ⅳ型组。4组采用实时荧光定量PCR法检测术前及术后1周血浆lncRNA HAGLR、BMP-2mRNA相对表达量,采用免疫组织化学法检测骨折组织BMP-2表达;Pearson相关法分析4组术后1周血浆lncRNA HAGLR与BMP-2表达的相关性,术前血浆lncRNA HAGLR与骨折组织BMP-2免疫组织化学评分的相关性。结果4组性别,年龄,损伤原因,合并半月板损伤、前交叉韧带撕脱、骨质疏松、局部感染及吸烟比率比较差异均无统计学意义(P>0.05)。4组术前及术后1周血浆lncRNA HAGLR、BMP-2 mRNA相对表达量比较差异均有统计学意义(P<0.05);血浆lncRNA HAGLR、BMP-2mRNA相对表达量术前在Ⅰ型组(8.75±0.79、12.52±0.52)、Ⅱ型组(7.10±0.93、10.03±0.88)、Ⅲ型组(4.23±0.81、9.02±0.99)、Ⅳ型组(4.14±0.75、5.56±0.69)依次降低(P<0.05),术后1周在Ⅰ型组(12.11±1.48、49.85±5.68)、Ⅱ型组(16.96±1.24、52.11±5.07)、Ⅲ型组(17.13±1.62、73.36±8.26)、Ⅳ型组(18.36±1.50、81.14±7.87)依次升高(P<0.05);4组术后1周血浆lncRNA HAGLR、BMP-2 mRNA相对表达量均高于术前(P<0.05)。术后1周Ⅰ、Ⅱ、Ⅲ、Ⅳ型组血浆lncRNA HAGLR与BMP-2表达均呈正相关(r=0.597,P=0.009;r=0.586,P=0.023;r=0.844,P=0.013;r=0.808,P=0.014)。4组骨折组织BMP-2免疫组织化学评分比较差异有统计学意义(P<0.05);Ⅰ型组骨折组织BMP-2免疫组织化学评分[(6.05±0.71)分]高于Ⅱ型组[(5.33±0.54)分]、Ⅲ型组[(4.09±0.45)分]、Ⅳ型组[(4.22±0.28)分](t=4.666,P=0.001;t=7.659,P=0.001;t=5.019,P=0.001),Ⅱ型组高于Ⅲ、Ⅳ型组(t=6.442,P=0.001;t=4.035,P=0.002),Ⅲ型组与Ⅳ型组比较差异无统计学意义(t=0.527,P=0.609)。Ⅰ、Ⅱ、Ⅲ、Ⅳ型组术前血浆lncRNA HAGLR表达与骨折组织BMP-2免疫组织化学评分均呈正相关(r=0.880,P=0.020;r=0.721,P=0.024;r=0.752,P=0.005;r=0.854,P=0.015)。结论胫骨平台骨折患者随骨折严重程度增加血浆lncRNA HAGLR、BMP-2表达降低,lncRNA HAGLR可能通过调控BMP-2表达影响骨组织的修复。

Objective To observe the expressions of plasma lncRNA HAGLR and bone morphogenetic protein-2(BMP-2)in patients with different types of tibial plateau fractures before and after operation,and to investigate the correlation between lncRNA HAGLR and BMP-2after healing.Methods Eighty patients with tibial plateau fractures undergoing surgical treatment were classified into 23patients with typeⅠ,45with typeⅡ,9with typeⅢ,and 3with typeⅣfratures according to Schatzker classification before operation.The relative expressions of plasma lncRNA HAGLR and BMP-2 mRNA in 4groups before and 1week after operation were detected by real-time fluorescence quantitative PCR.The expression of BMP-2in fracture tissues was detected by immunohistochemistry in 4groups.Pearson correlation method was used to analyze the correlation between lncRNA HAGLR and BMP-2mRNA 1week after operation in 4 groups,and the correlation between preoperative plasma lncRNA HAGLR and BMP-2 immunohistochemical scores in 4groups.Results There were no significant differences in the gender,age,fracture cause,and percentages of combined meniscus injury,anterior cruciate ligament rupture,osteoporosis,local infection and smoking history among 4groups(P>0.05).There were significant differences in the relative expressions of plasma lncRNA HAGLR and BMP-2 mRNAs before and 1week after operation among 4groups(P<0.05).The relative expressions of lncRNA HAGLR and BMP-2 mRNAs decreased gradually in turns in typeⅠgroup(8.75±0.79,12.52±0.52),typeⅡgroup(7.10±0.93,10.03±0.88),typeⅢgroup(4.23±0.81,9.02±0.99),and typeⅣgroup(4.14±0.75,5.56±0.69)before operation(P<0.05),increased gradually in turn in typeⅠgroup(12.11±1.48,49.85±5.68),typeⅡgroup(16.96±1.24,52.11±5.07),typeⅢgroup(17.13±1.62,73.36±8.26)and typeⅣgroup(18.36±1.50,81.14±7.87)1week after operation(P<0.05),and were higher in 4 groups 1 week after operation than those before operation(P<0.05).The expressions of lncRNA HAGLR were positively correlated with the expression of BMP-2in 4groups 1week after operation(r=0.597,P=0.009;r=0.586,P=0.023;r=0.844,P=0.013;r=0.808,P=0.014).There was significant difference in BMP-2 immunohistochemical score in fracture tissues in 4groups(P<0.05).The BMP-2immunohistochemical score in fracture tissues was higher in typeⅠgroup(6.05±0.71)than that in typeⅡgroup(5.33±0.54),typeⅢgroup(4.09±0.45),and typeⅣgroup(4.22±0.28)(t=4.666,P=0.001;t=7.659,P=0.001;t=5.019,P=0.001),was higher in typeⅡgroup than that in typeⅢgroup and typeⅣgroup(t=6.442,P=0.001;t=4.035,P=0.002),and showed no significant difference between typeⅢgroup and typeⅣgroup(t=0.527,P=0.609).The preoperative plasma expressions of lncRNA HAGLR were positively correlated with the immunohistochemical scores of BMP-2in fracture tissues in 4groups(r=0.880,P=0.020;r=0.721,P=0.024;r=0.752,P=0.005;r=0.854,P=0.015).Conclusion The expressions of plasma lncRNA HAGLR and BMP-2decrease with the increase of severity of tibial plateau fracture,and lncRNA HAGLR can influence the repair of bone tissue by regulating BMP-2expression.