晚期日本血吸虫病患者肝组织基质金属蛋白酶2和9的表达

Expression of Matrix Metalloproteinase 2 and 9 in Liver Tissue of Patients with Schistosomiasis Japonica

目的 研究基质金属蛋白酶2(MMP-2)、基质金属蛋白酶9(MMP-9)在晚期日本血吸虫病患者肝组织中的表达及意义。方法 26例晚期日本血吸虫病患者肝活检标本和5例正常人肝标本行常规病理检查,用MMP-2、MMP-9和Ⅳ型胶原(G-Ⅳ)单克隆抗体进行免疫组织化学染色进行定量和定位研究。结果 MMP-2主要表达在肝细胞浆、肝细胞膜和肝窦,肌成纤维细胞和血管内皮细胞也有表达。MMP-9主要表达在肝星状细胞、肝窦和肌成纤维细胞,偶见肝细胞浆和胆管上皮细胞表达。晚期日本血吸虫病患者肝组织MMP-2、MMP-9和G-Ⅳ的表达明显高于正常人(P<0.05),随着汇管区炎症活动度和肝纤维化程度的升高,MMP-2的表达也明显增强(P<0.01),MMP-9的表达无明显改变(P>0.05),C-Ⅳ表达与MMP-2呈同步关系。结论 MMP-2与日本血吸虫病肝纤维化的发生、发展有关,MMP-9表达与日本血吸虫病肝纤维化的发生有关。

Objective To explore the change of matrix metalloproteinase-2(MMP-2) and matrix metalloproteinase-9 (MMP-9) expression in liver tissue of the patients with schistosomiasis japonica. Methods Liver biopsy materials were examined pathomorphologically in 26 patients with schistosomiasis in advanced stage and 5 cases without the disease as control. The expression of MMP-2 , MMP-9 and C-Ⅳwere studied by immunohistochemistry, and result was analyzed by picture quantitative analysis technique. Results Immnoreactive MMP-2 was mainly expressed in the plasma, the membrane of hepato-cytes and hepatic sinusoids, it was also found in myofibroblast cells and endothelial cells of blood vessel. Immnoreactive MMP-9 was observed in hepatic stellate cells, sinusoids and myofibroblast cells, sometimes it was also seen in the plasma of hepato-cytes and epithelial cells of bile duct. The expression of MMP-2, MMP-9 and C-IV was significandy stronger in patients with advanced schistosomiasis than that of the control(P<0.05). The expression of MMP-2 was relevant to the inflammation grade and stage of liver fibrosis(P<0.01). The expression of MMP-9 did not show significant change(P>0.05) and the expression of C-Ⅳ was consistent with that of MMP-2. Conclusion The study indicates that increased expression of MMP-2 participated in the initiation and development process of liver fibrosis, MMP-9 was related to the initiation of liver fibrosis and pathological change existed in hepatic sinusoids in advanced schistosomiasis japonica.