目的:探讨急性冠状动脉(冠脉)综合征患者血小板表面细胞外基质金属蛋白酶诱导因子(EMMPRIN)、糖蛋白Ⅵ(GPⅥ)的水平与动脉粥样硬化斑块稳定性的关系。方法:顺序选取138例冠心病患者,分为急性冠脉综合征组86例,稳定性心绞痛组52例,另选4...目的:探讨急性冠状动脉(冠脉)综合征患者血小板表面细胞外基质金属蛋白酶诱导因子(EMMPRIN)、糖蛋白Ⅵ(GPⅥ)的水平与动脉粥样硬化斑块稳定性的关系。方法:顺序选取138例冠心病患者,分为急性冠脉综合征组86例,稳定性心绞痛组52例,另选40例冠脉造影结果正常者为对照组。采用二次离心法提取血小板,流式细胞仪检测外周血血小板表面EMMPRIN和GPⅥ表达水平。为进一步研究,根据冠脉造影斑块形态特征分为Ⅰ、Ⅱ、Ⅲ型;并接受64层螺旋计算机断层摄影术(CT)冠脉成像检查,根据冠脉粥样斑块CT值分为软斑块、纤维斑块、钙化斑块,比较不同斑块形态及类型间EMMPRIN及GPⅥ表达水平变化。结果:(1)急性冠脉综合征组、稳定性心绞痛组血小板表面EMMPRIN、GPⅥ表达水平较对照组升高(EMMPRIN MFI:5.82±0.81、3.45±0.48 vs 1.35±0.15)、(GPⅥMFI:16.22±5.27、8.20±2.87 vs 4.14±1.17);且急性冠脉综合征组较稳定性心绞痛组升高明显,差异均有统计学意义(P均<0.05)。(2)急性冠脉综合征组Ⅱ型斑块者、Ⅲ斑块者血小板表面EMMPRIN、GPⅥ表达水平较I型斑块者升高(EMMPRIN MFI:6.35±1.05、4.09±0.67 vs 2.45±0.27)、(GPⅥMFI:19.50±4.55、10.81±2.33 vs 5.89±1.28);Ⅱ型斑块者较Ⅲ型斑块者也有明显升高,差异均有统计学意义(P均<0.05)。(3)急性冠脉综合征组软斑块者、纤维斑块者血小板表面EMMPRIN、GPⅥ表达水平较钙化斑块者升高(EMMPRIN MFI:6.18±1.01、3.87±0.56 vs 2.43±0.25)、(GPⅥMFI:19.14±4.27、11.08±1.94 vs 5.96±0.99);软斑块者较纤维斑块者也有明显升高,差异均有统计学意义(P均<0.05)。(4)冠心病患者血小板表面EMMPRIN表达水平与斑块类型[95%可信区间(CI):-0.359^-0.206,标准化的回归系数(β):-0.211]呈负相关,与临床类型(95%CI0.893~1.034,β:0.893)呈正相关,血小板表面GPⅥ表达水平与斑块类型(95%CI-1.222^-0.586,β:-0.181)呈负相关,与临床类型(95%CI 3.576~4.164,β:0.960)呈正相关。结论:急性冠脉综合征组患者血小板表面EMMPRIN、GPⅥ表达水平与动脉硬化斑块的稳定性关系密切,两者是严重冠脉病变的相关危险因素,对于动脉硬化早期的诊断可能有一定预测价值。展开更多
BACKGROUND Chronic constipation is a gastrointestinal functional disease that seriously harms physical and mental health and impacts the quality of life of patients.Its incidence rate is 2%-27%.Slow transit constipati...BACKGROUND Chronic constipation is a gastrointestinal functional disease that seriously harms physical and mental health and impacts the quality of life of patients.Its incidence rate is 2%-27%.Slow transit constipation(STC)is a common type of chronic functional constipation,accounting for 10.3%-45.5%of such cases.Scholars have performed many studies on the pathogenesis of STC.These studies have indicated that the occurrence of STC may be related to multiple factors,such as dysfunction of the enteric nervous system,interstitial cells of Cajal(ICC)damage,and changes in neurotransmitters regulating intestinal peristalsis.AIM To investigate the role of Tenascin-X(TNX)in regulating the TGF-β/Smad signaling pathway in the pathogenesis of STC.METHODS This study included an experimental group and a control group.The experimental group included 28 patients with severe colonic STC,and the control group included 18 patients with normal colon tissues.Immunohistochemistry(IHC)was used to detect c-Kit,a specific marker of the ICC.Western blot,immunofluorescence,and IHC were used to detect the localization and expression of TNX and TGF-β/Smad.RESULTS IHC showed that the number of ICC with positive c-Kit expression was significantly reduced in the colon of STC patients(22.17±3.28 vs 28.69±3.53,P<0.05)and that the distribution was abnormal.Western blot results showed that c-Kit and Smad7 levels were significantly decreased in the colon of STC patients(c-kit:0.462±0.099 vs 0.783±0.178,P<0.01;Smad7:0.626±0.058 vs 0.799±0.03,P<0.01)and that TNX and Smad2/3 levels were higher in the STC group(TNX:0.868±0.028 vs 0.482±0.032,P<0.01).There was no significant difference in TGF-βbetween the two groups(0.476±0.028 vs 0.511±0.044,P=0.272).Pearson correlation analysis showed that the TNX protein exhibited a strong correlation with Smad2/3 and Smad7(P<0.05,|R|>0.8)and TGF-β(P<0.05,|R|=0.7).CONCLUSION The extracellular matrix protein TNX may activate the TGF-β/Smad signaling pathway by upregulating the Smad 2/3 signaling protein and thereby induce slight or complete epithelial stromal cell transformation,leading to an abnormal distribution and dysfunction of ICC in the diseased colon,which promotes the occurrence and development of STC.展开更多
文摘目的:探讨急性冠状动脉(冠脉)综合征患者血小板表面细胞外基质金属蛋白酶诱导因子(EMMPRIN)、糖蛋白Ⅵ(GPⅥ)的水平与动脉粥样硬化斑块稳定性的关系。方法:顺序选取138例冠心病患者,分为急性冠脉综合征组86例,稳定性心绞痛组52例,另选40例冠脉造影结果正常者为对照组。采用二次离心法提取血小板,流式细胞仪检测外周血血小板表面EMMPRIN和GPⅥ表达水平。为进一步研究,根据冠脉造影斑块形态特征分为Ⅰ、Ⅱ、Ⅲ型;并接受64层螺旋计算机断层摄影术(CT)冠脉成像检查,根据冠脉粥样斑块CT值分为软斑块、纤维斑块、钙化斑块,比较不同斑块形态及类型间EMMPRIN及GPⅥ表达水平变化。结果:(1)急性冠脉综合征组、稳定性心绞痛组血小板表面EMMPRIN、GPⅥ表达水平较对照组升高(EMMPRIN MFI:5.82±0.81、3.45±0.48 vs 1.35±0.15)、(GPⅥMFI:16.22±5.27、8.20±2.87 vs 4.14±1.17);且急性冠脉综合征组较稳定性心绞痛组升高明显,差异均有统计学意义(P均<0.05)。(2)急性冠脉综合征组Ⅱ型斑块者、Ⅲ斑块者血小板表面EMMPRIN、GPⅥ表达水平较I型斑块者升高(EMMPRIN MFI:6.35±1.05、4.09±0.67 vs 2.45±0.27)、(GPⅥMFI:19.50±4.55、10.81±2.33 vs 5.89±1.28);Ⅱ型斑块者较Ⅲ型斑块者也有明显升高,差异均有统计学意义(P均<0.05)。(3)急性冠脉综合征组软斑块者、纤维斑块者血小板表面EMMPRIN、GPⅥ表达水平较钙化斑块者升高(EMMPRIN MFI:6.18±1.01、3.87±0.56 vs 2.43±0.25)、(GPⅥMFI:19.14±4.27、11.08±1.94 vs 5.96±0.99);软斑块者较纤维斑块者也有明显升高,差异均有统计学意义(P均<0.05)。(4)冠心病患者血小板表面EMMPRIN表达水平与斑块类型[95%可信区间(CI):-0.359^-0.206,标准化的回归系数(β):-0.211]呈负相关,与临床类型(95%CI0.893~1.034,β:0.893)呈正相关,血小板表面GPⅥ表达水平与斑块类型(95%CI-1.222^-0.586,β:-0.181)呈负相关,与临床类型(95%CI 3.576~4.164,β:0.960)呈正相关。结论:急性冠脉综合征组患者血小板表面EMMPRIN、GPⅥ表达水平与动脉硬化斑块的稳定性关系密切,两者是严重冠脉病变的相关危险因素,对于动脉硬化早期的诊断可能有一定预测价值。
文摘BACKGROUND Chronic constipation is a gastrointestinal functional disease that seriously harms physical and mental health and impacts the quality of life of patients.Its incidence rate is 2%-27%.Slow transit constipation(STC)is a common type of chronic functional constipation,accounting for 10.3%-45.5%of such cases.Scholars have performed many studies on the pathogenesis of STC.These studies have indicated that the occurrence of STC may be related to multiple factors,such as dysfunction of the enteric nervous system,interstitial cells of Cajal(ICC)damage,and changes in neurotransmitters regulating intestinal peristalsis.AIM To investigate the role of Tenascin-X(TNX)in regulating the TGF-β/Smad signaling pathway in the pathogenesis of STC.METHODS This study included an experimental group and a control group.The experimental group included 28 patients with severe colonic STC,and the control group included 18 patients with normal colon tissues.Immunohistochemistry(IHC)was used to detect c-Kit,a specific marker of the ICC.Western blot,immunofluorescence,and IHC were used to detect the localization and expression of TNX and TGF-β/Smad.RESULTS IHC showed that the number of ICC with positive c-Kit expression was significantly reduced in the colon of STC patients(22.17±3.28 vs 28.69±3.53,P<0.05)and that the distribution was abnormal.Western blot results showed that c-Kit and Smad7 levels were significantly decreased in the colon of STC patients(c-kit:0.462±0.099 vs 0.783±0.178,P<0.01;Smad7:0.626±0.058 vs 0.799±0.03,P<0.01)and that TNX and Smad2/3 levels were higher in the STC group(TNX:0.868±0.028 vs 0.482±0.032,P<0.01).There was no significant difference in TGF-βbetween the two groups(0.476±0.028 vs 0.511±0.044,P=0.272).Pearson correlation analysis showed that the TNX protein exhibited a strong correlation with Smad2/3 and Smad7(P<0.05,|R|>0.8)and TGF-β(P<0.05,|R|=0.7).CONCLUSION The extracellular matrix protein TNX may activate the TGF-β/Smad signaling pathway by upregulating the Smad 2/3 signaling protein and thereby induce slight or complete epithelial stromal cell transformation,leading to an abnormal distribution and dysfunction of ICC in the diseased colon,which promotes the occurrence and development of STC.