阴道局部免疫因子HBD-2及LL-37与RVVC的相关性研究

发布时间：2018-09-17 20:15

【摘要】：目的了解外阴阴道假丝酵母菌病的致病菌谱，并通过检测复发性外阴阴道假丝酵母菌病（RVVC）患者、单纯外阴阴道假丝酵母菌病（VVC）患者和健康带菌者阴道灌洗液中HBD-2、LL-37的蛋白浓度以及阴道局部脱落细胞中HBD-2、LL-37mRNA的表达水平，分析HBD-2、LL-37与VVC临床症状严重程度的关系，探讨HBD-2、LL-37与RVVC发病的关系及阴道局部固有免疫在RVVC的发病中的作用。方法收集RVVC患者28例，VVC患者30例以及健康带菌者30例作为研究对象。所有研究对象记录其一般资料，分泌物行真菌培养鉴定，并根据VVC评分标准评分。留取所有研究对象的阴道灌洗液标本，用ELISA法测定灌洗液上清中HBD-2、LL-37的蛋白浓度，用荧光定量PCR法测定阴道局部脱落细胞中HBD-2、LL-37的mRNA表达水平。应用SPSS17.0软件，采用单因素方差分析、χ2检验，检验水准为α=0.05。结果1真菌培养结果显示VVC组中非白假丝酵母菌占3.34%，，RVVC组中非白假丝酵母菌占14.28%，两组差异无统计学意义（P＞0.05）。2HBD-2的蛋白浓度及mRNA水平：对照组、VVC组及RVVC组的HBD-2蛋白浓度分别为：（64.31±13.45）μg/L、（72.27±11.92）μg/L、（56.97±10.36）μg/L。对照组、VVC组及RVVC组的HBD-2mRNA表达水平分别为：1.03±0.06、1.28±0.13、0.81±0.28。VVC组HBD-2的蛋白浓度及mRNA水平显著高于对照组及RVVC组（P＜0.05），RVVC组HBD-2的蛋白浓度及mRNA水平较对照组及VVC组低（P＜0.05）。3LL-37的蛋白浓度及mRNA水平：对照组、VVC组及RVVC组的LL-37蛋白浓度分别为：（8.92±0.68）μg/L、（12.41±1.67）μg/L、（5.99±0.55）μg/L。对照组、VVC组及RVVC组LL-37mRNA表达水平分别为：1.01±0.04、1.45±0.25、0.83±0.19。VVC组LL-37的蛋白浓度及mRNA水平显著高于对照组及RVVC组（P＜0.05），RVVC组LL-37的蛋白浓度及mRNA水平较对照组及VVC组低（P＜0.05）。4重度VVC组HBD-2、LL-37蛋白浓度比轻、中度VVC组和对照组低（P＜0.05），差异有统计学意义。结论1VVC及RVVC的致病菌中非白假丝酵母菌比例有上升趋势，但主要致病菌种仍然是白假丝酵母菌。2正常阴道局部存在HBD-2及LL-37的少量表达，提示HBD-2、LL-37在阴道局部固有免疫防御中有一定作用。3VVC患者发病过程中阴道局部通过增加HBD-2、LL-37的分泌以抵抗假丝酵母菌的侵袭。RVVC患者阴道局部HBD-2、LL-37的低水平表达可能和其反复发作有关。4阴道局部HBD-2、LL-37的表达水平降低可能和和假丝酵母菌病的症状加重有关。
[Abstract]:Objective to investigate the pathogenic bacteria spectrum of vulvovaginal candidiasis and to detect the (RVVC) patients with recurrent vulvovaginal candidiasis. The protein concentration of HBD-2,LL-37 in vaginal lavage fluid and the expression level of HBD-2,LL-37mRNA in vaginal exfoliated cells in (VVC) patients with vulvovaginal candidiasis and healthy carriers were analyzed. The relationship between HBD-2,LL-37 and the severity of clinical symptoms of VVC was analyzed. To investigate the relationship between HBD-2,LL-37 and RVVC and the role of local immunity of vagina in the pathogenesis of RVVC. Methods 28 patients with RVVC and 30 healthy carriers were studied. All subjects recorded their general data, the secretion was identified by fungal culture, and scored according to the VVC score. The samples of vaginal lavage fluid were collected from all the subjects. The protein concentration of HBD-2,LL-37 in the supernatant of the lavage fluid was determined by ELISA method, and the mRNA expression of HBD-2,LL-37 in the local exfoliated cells of vagina was determined by fluorescence quantitative PCR method. Using SPSS17.0 software, single factor analysis of variance, 蠂 2 test, the test level is 伪 0. 05. Results 1 the results of fungal culture showed that non-white candida cerevisiae accounted for 14.28 in VVC group. There was no significant difference between the two groups (P > 0.05) .2HBD-2 protein concentration and mRNA level were (64.31 卤13.45) 渭 g / L, (72.27 卤11.92) 渭 g / L, (56.97 卤10.36) 渭 g / L in control group and RVVC group, respectively. The HBD-2mRNA expression levels in the control group and the RVVC group were 1.03 卤0.06 卤1.28 卤0.13 卤0.81 卤0.28.VVC, respectively, which were significantly higher than those in the control group and the RVVC group (P < 0. 05). The HBD-2 protein concentration and mRNA level in the RVVC group were significantly lower than those in the control group and the VVC group (P < 0. 05). 3LL-37 protein concentration was significantly lower than that in the control group and the RVVC group (P < 0. 05). The concentration of LL-37 protein in control group and RVVC group were (8.92 卤0.68) 渭 g / L, (12.41 卤1.67) 渭 g / L, (5.99 卤0.55) 渭 g / L, respectively. The LL-37mRNA expression levels in the control group and the RVVC group were 1.01 卤0.04 and 1.45 卤0.25 卤0.83 卤0.19.VVC, respectively, and the LL-37 protein and mRNA levels were significantly higher than those in the control group and the RVVC group (P < 0. 05). The LL-37 protein concentration and mRNA level in the RVVC group were significantly lower than those in the control group and the VVC group (P < 0. 05). The HBD-2,LL-37 protein levels in the severe VVC group were significantly lower than those in the control group and the VVC group (P < 0. 05). The moderate VVC group was lower than the control group (P < 0. 05). Conclusion the proportion of non-Candida albicans which are pathogenic to 1VVC and RVVC is increasing, but the main pathogen is the presence of a small amount of HBD-2 and LL-37 in normal vagina of Candida albicans. The results suggest that HBD-2,LL-37 may play a role in the local innate immune defense of vagina. 3 the vaginal area may resist the invasion of Candida cerevisiae by increasing the secretion of HBD-2,LL-37 during the onset of VVC. The low level expression of HBD-2,LL-37 in vagina of patients with VVC may be reversed. The decrease of HBD-2,LL-37 expression in the vagina may be related to the exacerbation of the symptoms of Candida cerevitis.
【学位授予单位】：河北联合大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R711.31

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