下颌前移矫治器对OSAHS腭咽组织和血浆中炎症因子的影响

Effects of mandibular advancement device on inflammatory factors in palatopharyngeal tissue and plasma of OSAHS

目的探讨下颌前移矫治器(mandibular advancement device,MAD)对阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)兔腭咽组织和血浆中白细胞介素1β(interleukin 1β,IL-1β),白细胞介素6(interleukin 6,IL-6)和肿瘤坏死因子α(tumor necrosis factorα,TNF-α)的影响,为临床工作中治疗OSAHS提供理论基础。方法30只雄性新西兰兔随机分为三组,OSAHS组和MAD组建立OSAHS模型,MAD组戴MAD,对照组不作处理。仰卧位睡眠8周(4~6 h/d),酶联免疫吸附测定法(enzyme linked immunosorbent assay,ELISA)测定血浆中炎症因子的表达,免疫组织化学(immunohistochemistry,IHC)染色和实时荧光定量聚合酶链反应(real-time quantitative polymerase chain reaction,qRT-PCR)测定腭咽组织中炎症因子表达。结果ELISA实验结果显示OSAHS组血清中IL-1β、IL-6、TNF-α的含量均显著高于对照组和MAD组(P<0.05),对照组和MAD组IL-1β、IL-6、TNF-α差异均无统计学意义(P>0.05)。qRT-PCR结果显示OSAHS组腭咽组织中炎症因子基因表达量比对照组和MAD组均显著升高。TNF-α免疫组织化学显示OSAHS组腭咽组织中TNF-α阳性细胞明显多于对照组和MAD组。结论MAD治疗可以减轻OSAHS引起的全身及腭咽组织的炎症反应。

Objective To investigate the effects of mandibular advancement device(MAD)on interleukin 1β(IL-1β),interleukin 6(IL-6)and tumor necrosis factorα(TNF-α)in palatopharyngeal tissue and plasma of rabbits with obstructive sleep apnea hypopnea syndrome(OSAHS),and to provide a theoretical basis for the clinical treatment of OSAHS.Methods A total of 30 male New Zealand rabbits were randomly divided into three groups.The OSAHS model was induced in OSAHS group and MAD group.The animals were equipped with MADs in MAD group and no treatment was given in the control group.All the animals were kept to sleep in supine position for 8 weeks(4-6 h/d).The expression of inflammatory factors in plasma was determined by enzyme linked immunosorbent assay(ELISA),and the expression of inflammatory factors in palatopharyngeal tissue was determined by immunohistochemistry(IHC)and real-time quantitative polymerase chain reaction(qRT-PCR).Results The results of ELISA showed that the levels of IL-1β,IL-6 and TNF-αin OSAHS group were significantly higher than those in the control group and MAD group(P<0.05).There was no significant difference in levels of IL-1β,IL-6 and TNF-αbetween the control group and MAD group(P>0.05).The results of qRT-PCR showed that the gene expression of inflammatory factors in palatopharyngeal tissues was significantly higher in OSAHS group than in the control group and MAD group.IHC showed that positive cells for TNF-αin palatopharyngeal tissue were significantly higher in OSAHS group than those in the control group and MAD group.Conclusion MAD can rescue the systemic and palatopharyngeal inflammation caused by OSAHS.