PAR2-PKC信号通路在胃食管反流病黏膜损伤中的作用

Role of PAR2-PKC signaling pathway in mucosal injury in gastroesophageal reflux disease

目的 研究PAR2-PKC信号通路在胃食管反流病黏膜损伤中的作用。方法 据GerdQ评分>8分、内镜下食管黏膜情况确定RE组、RE炎旁对照组、NERD组患者;无GERD典型临床症状、内镜下食管黏膜正常确定正常对照组;内镜下取RE组食管黏膜糜烂处、距糜烂外周5 cm处正常黏膜组织,以及NERD组、正常对照组食管齿状线上5 cm食管黏膜组织进行免疫组化、RT-PCR实验检测各组食管黏膜组织中PAR2、PKC的mRNA表达情况。结果 共收集84例患者(RE组25例;RE炎旁对照组19例;NERD组24例;正常对照组16例);免疫组化结果显示,PAR2、PKC蛋白在NERD组阳性表达率明显高于其他三组,但PAR2、PKC蛋白在各分组食管黏膜组织中表达差异无统计学意义(P>0.05)。RT-PCR结果提示,PKC mRNA检测量在各组间存在显著差异,PAR2 mRNA在正常对照组vs RE组、RE炎旁对照组vs NERD组、NERD组vs正常对照组组间存在显著差异性;正常对照组vs RE组、正常对照组vs RE炎旁对照组、NERD组vs RE组间无差异。结论 PAR2-PKC信号通路激活可能参与GERD中RE、NERD患者食管表面黏膜炎症以及NERD患者内脏高敏感过程。

Objective To study the role of PAR2-PKC signaling pathway in mucosal injury in gastroesophageal reflux disease.Methods RE group,RE para-inflammatory control group and NERD group were determined according to GerdQ score>8 and esophageal mucosa under endoscopy.Patients without typical clinical symptoms of GERD and normal esophageal mucosa under endoscopy were identified as normal group.Under endoscopy,the erosive part of esophageal mucosa in RE group,the normal mucosa 5 cm away from the periphery of erosive,and the esophageal mucosa 5 cm on the dentate line of esophagus in NERD group and normal group were taken for immunohistochemical and RT-PCR tests to detect the differences of mRNA expression of PAR2 and PKC in esophageal mucosa in each group.Results 84 patients were collected(25 cases in RE group,19 cases in RE para-inflammatory control group,24 cases in NERD group and 16 cases in normal control group).Immunohistochemical results showed that the positive expression rate of PAR2 and PKC protein in NERD group was significantly higher than that in the other three groups,but there was no difference in the expression of PAR2 and PKC protein in esophageal mucosa of each group.The results of RT-PCR showed that there were significant differences in the amount of PKC mRNA among the groups,and there were significant differences in the amount of PAR2 mRNA among the normal control group and RE group,RE para-inflammatory control group and NERD group,NERD group and normal control group.There was no significant difference in PAR2 between normal control group and RE group,normal control group and RE para-inflammatory control group,NERD group and RE group.Conclusion The activation of PAR2-PKC signaling pathway may be involved in the process of esophageal mucosal inflammation in patients with RE and NERD and visceral hypersensitivity in patients with NERD.