NLRP3炎性小体介导的炎性过程在肠易激综合征发生中的作用
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摘要
研究背景:
     肠道菌群失调及炎性反应在肠易激综合征IBS中的作用机制尚不完全清楚。IL-lbeta是主要由单核巨噬细胞合成分泌的重要炎性介质,它对胃肠分泌和运动有影响,还可使胃肠道胆碱能神经对乙酰胆碱及其他炎性介质的敏感性增高。IBS患者单核细胞给予脂多糖LPS的诱导后IL-lbeta基线水平则会较健康对照显著增高。这让我们关注到了IL-1beta释放的信号传导通路,第一信号由Toll样受体和细菌LPS结合,诱导IL-1beta前体合成;第二信号通过激活NLRP3炎性小体使IL-lbeta前体转化成有生物活性的IL-lbeta. NLRP3炎性小体是一种多蛋白复合物,可以被多种细菌所激活,它在IBS患者和健康对照组之间的差异对于我们研究肠道菌群失调在IBS中的作用具有重要的意义。
     目的:
     通过检测IBS患者NLRP3信号传导通路改变分析NLRP3炎性小体介导的IL-lbeta的释放的炎性过程在IBS发生机制中的作用。(?)方法:
     乙状结肠粘膜标本取自36例IBS患者(腹泻型16例,便秘型20例)、18例正常对照、18例溃疡性结肠炎患者(阳性对照)。应用免疫组织化学法测定结肠粘膜NLRP3的表达量,应用ELISA法检测结肠粘膜中caspase-1和IL-1beta含量。
     结果:
     腹泻组和便秘组结肠粘膜IL-1beta含量均值(48.33±15.72 VS 49.46±23.47 VS 38.26±13.24)和caspase-1含量均值(527.24±381.60 VS 559.45±299.28 VS 426.06±274.49)较正常组升高,但无显著性差异(P>0.05)。
     溃结组、腹泻组、便秘组分别与正常对照组比较结肠粘膜NLRP3免疫组织化学染色间质阳性细胞计数(248.62±34.91 VS 109.88±33.71 VS115.50±31.37 VS 27.38±10.86)和平均光密度(225.20±19.04VS 178.37±23.85VS180.62±39.07VS 153.87±20.03)均有显著差异(P值均<0.05)。
     正常对照组的结肠粘膜IL-1beta含量分别与结肠粘膜NLRP3免疫组织化学染色间质阳性细胞计数和结肠粘膜NLRP3免疫组织化学染色间质平均光密度有很好的相关性(P<0.05),而腹泻组和便秘组中结肠粘膜IL-1beta含量与结肠粘膜NLRP3免疫组织化学染色间质阳性细胞计数和结肠粘膜NLRP3免疫组织化学染色间质平均光密度无相关性(P>0.05)。
     结论:
     IBS患者乙状结肠粘膜间质中NLRP3含量高于正常对照组,其乙状结肠粘膜中caspase-1和IL-1beta的含量部分患者较正常对照组增加。
     与正常对照组相比,IBS患者乙状结肠粘膜间质中NLRP3表达量与结肠粘膜IL-1beta含量不成比例,这提示IBS患者肠粘膜单核巨噬细胞NLRP3表达量增加,但只有部分IBS患者被激活。
     单核、巨噬细胞中NLRP3表达量增高,提高了肠易激综合征患者对病原微生物刺激的敏感性,从而导致有病原微生物的作用的患者或肠段,存在NLRP3炎性小体介导的IL-1beta合成分泌的显著增加。
Objective:
     Detect changes of NLRP3 signal transduction pathway to analyze NLRP3-mediated IL-lbeta release inflammatory process in the irritable bowel syndrome pathogenesis.
     Methods:
     Sigmoid colon mucosa specimens were collection from 36 patients with IBS (16 cases of diarrhea IBS, constipation IBS in 20 cases) and 18 normal controls,18 patients with ulcerative colitis (positive control). Immunohistochemical staining determined the NLRP3 expression of colonic mucosa and we applied ELISA assay to detact caspase-1 and IL-lbeta levels of the mucosa.
     Result:
     Caspase-1 and IL-lbeta levels of sigmoid colon mucosa increased in patients with irritable bowel syndrome, but no statistical significance,
     In the NLRP3 Immunohistochemistry staining,the positive cells number and the mean density of the colon interstitial mucosa was higher in the IBS group than the normal control group.
     IL-lbeta levels and NLRP3 expression of interstitial colon,including positive cells and mean density, had good correlation in the normal control group. IL-1beta levels and NLRP3 expression of interstitial colon had poor correlation in the IBS group.
     Conclusions:
     NLRP3 expression of the sigmoid colon interstitial mucosa was higher in the IBS group than the normal control group. Caspase-1 and IL-lbeta levels of sigmoid colon mucosa increased iust in some patients with irritable bowel syndrome.
     Compared with normal controls,the expression of NLRP3 in colon interstitial didn't match the colon IL-lbeta levels in patients with irritable bowel syndrome. This suggests that NLRP3 expression of monocytes and macrophages was higher in the IBS group,while NLRP3 inflammasome only activated in part of the patients.
     Increased expression of NLRP3 in monocytes and macrophages improved the sensitivity to the stimulation of the pathogenic microorganisms. So when the pathogenic microorganisms interact with the intestinal mucosa,the NLRP3 inflammasome mediated synthesis and secretion of IL-lbeta significantly increasd in patients with IBS.
引文
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