肥大细胞及其雌激素受体在肠易激综合征发病机制中的作用

Intestine mast cell and expression of oestrogen receptor in patients with irritable bowel syndrome

目的 探讨肠易激综合征(IBS)患者肠道内雌、孕激素受体阳性细胞和肥大细胞相关性及其临床意义。方法 经结肠镜钳取24名正常人和59例肠易激综合征患者回肠末端、盲肠和降结肠黏膜,分别采用抗人肥大细胞类胰酶抗体标识肥大细胞和抗人雌、孕激素受体抗体标识肠黏膜上雌、孕激素受体;同时应用免疫组化双染(DAB和BCIP/NBT染色)检测肥大细胞上雌激素受体的存在。结果 雌激素受体阳性细胞与肥大细胞显著相关,相关系数为0.884(P<0.01);肠道黏膜未见孕激素受体表达;IBS患者回肠末端和回盲部黏膜肥大细胞有雌激素受体表达。结论 肥大细胞为雌激素在消化道的重要靶点,肥大细胞上存在雌激素受体在IBS病理生理过程中发挥一定作用。

Objective To investigate the role of oestrogen receptors and enteric mast cells in the pathogenesis of irritable bowel syndrome (IBS) . Methods Biopsies from 59 patients with IBS and 24 control subjects were analyzed blindly for the number of mast cell ( MC ) , estrogen receptors and progestogen receptors in terminal ileum , caecum and descending colon (DC). Immunohistochemical methods were used to detect the estrogen receptors (ER) , progestogen receptors (PR) and MC. And double Immunohistochemical staining was used to manifest the expression of oestrogen receptors in intestinal MC. Results The cells positive for ER were morphologically similar to the MC (R = 0. 884, P < 0. 01) , they coincided exactly with cells labeled as MC by dual immunostaining. Enteric MC was shown to express ER only. Conclusions Enteric MC expression of high affinity estrogen receptors may help to explain why IBS occurs primarily in women and IBS associated symptoms tend to be worst at the menstruation period. The antagonists of the MC products and estrogen receptors or the MC stabilizer may perhaps have some beneficial effects on the IBS.