梅尼埃病患者内淋巴囊组织中细胞因子的表达

Expression of Cytokines in the Endolymphatic Sac in Patients with Meniere's Disease

目的内淋巴囊(endolymphatic sac,ES)的炎症变化可能涉及梅尼埃病(Meniere’s disease,MD)的发病机制。通过检测MD患者ES组织的促炎细胞因子表达,探讨ES炎症反应在MD发病机制中的作用。方法收集单侧MD患者行内淋巴导管夹闭手术获取的ES标本和听神经瘤(acoustic neuroma,AN)患者行迷路入路切除手术获取的ES标本,采用免疫组化检测ES组织中肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)和干扰素γ(interferon-γ,IFN-γ)的表达。结果9例MD患者ES组织中TNF-α均阳性表达,其中强表达5例,中等表达3例,弱表达1例;IFN-γ阳性表达7例,其中强表达4例,中等表达3例。10例AN患者ES组织中TNF-α弱阳性表达4例,IFN-γ为阴性表达。结论促炎细胞因子TNF-α和IFN-γ在MD患者ES上皮细胞呈阳性表达,MD患者ES组织存在炎性病理变化,这可能与内淋巴积水形成有关。

Objectiv Immune mediated inflammatory changes in the endolymphatic sac(ES)may underlie the mechanism of Meniere's disease(MD).The aim of the present study was to study the role of expression of proinflammatory cytokines in the ES in patients with MD as potential mechanisms underlying MD.Methods Human ES tissue was collected from patients with unilateral MD and patients with acoustic neuroma(AN)during surgery.Immunohistochemical techniques were used to detect expression of tumor necrosis factor-α(TNF-α)and interferon-γ(IFN-γ).Results Positive immunostaining of TNF-αwas identified in the ES epithelium,as well as in subepithelial connective-tissue fibroblasts,in all 9 patients with MD,with strong epithelial cells staining in 5 patients,moderate levels of staining in 3 patients and weak staining in 1 patient.IFN-γimmunoreactivity was seen in the epithelial lining of the ES in 7 out of the 9 patients,with strong staining in 4 and moderate staining in 3 patients.In contrast,in 10 ES specimens from patients with AN,only weak TNF-αstaining of epithelial cells was seen in 4 and negative in 6,with no expression of IFN-γ.Conclusions Positive expression of TNF-αand IFN-γin the ES in patients with MD provides direct evidence of increased immunologic activities in the ES microenvironment in patients with unilateral MD,suggesting that local inflammatory responses may be a mechanism for this disease.