Rho GTP酶在肌筋膜扳机点肌小节中的表达及机制研究

发布时间：2018-03-15 21:42

本文选题：肌筋膜扳机点　切入点：肌筋膜疼痛综合征　出处：《山东大学》2017年硕士论文　论文类型：学位论文

【摘要】：背景及目的:肌筋膜扳机点(MTrPs)是肌筋膜疼痛综合征(MPS)关键的病因机制和临床治疗靶点,多位于受累骨骼肌的条索或硬结上。组织病理学证实,MTrPs由异常收缩的肌小节构成,而肌小节异常收缩的机制目前仍不完全清楚。Rho GTP酶及下游激酶ROCK通过Ca2+敏感性机制在平滑肌收缩的维持中发挥重要作用。骨骼肌收缩机制与平滑肌应有相似之处。因此推测,Rho GTP酶(Rho.Racl.Cdc42等)及ROCK可能在MTrPs肌小节持续性异常收缩中发挥重要调节作用。本研究的目的是观察Rho、Rac1、Cdc42及ROCK在MTrPs部位及其邻近肌小节中的表达情况。方法:斜方肌中含有MTrPs的MPS患者20例为病例组(M组),不含MTrPs的颈椎手术病人10例为对照组(C组)。于M组受试者斜方肌的条索上定位MTrPs,SuperCore活检针穿刺活检;于C组受试者斜方肌相应部位进行活检。HE及Masson染色法观察MTrPs肌组织形态学改变;免疫组化法检测Rho(A-C)、Racl、Cdc42及ROCK2的表达。结果:HE染色:纵切面中,C组肌小节排列整齐均匀,横纹间距为1.91(0.19)um。M组肌小节异常收缩部位(a部位)的横纹间距为0.71(0.32)um(p0.05 vs.C组);其邻近的肌小节拉长部位(b部位)的横纹间距为2.33(0.31)um(p0.05 vs.C组;p0.01vs.M组a部位)。横切面中,C组及M组肌纤维的平均直径分别为 37.37±3.72um 及 82.61±19.48um(p0.01)。Masson染色:C组及M组肌纤维均呈红染,肌纤维之间有轻微蓝染,但肌纤维上绝无蓝染现象。免疫组化:①Rho及ROCK:C组肌纤维中Rho(A-C)及ROCK2均匀表达,主要位于肌细胞质中。与C组相比,M组肌小节异常收缩部位(a部位)胞质中Rho及ROCK2的表达量明显减少(p0.01),但细胞膜及膜周缘胞质区可见Rho及ROCK2的表达。与M组a部位相邻的肌小节拉长部位(b部位)胞质中Rho及ROCK2的表达量相对增加(p0.05 vs.M组a部位),但与C组相比无统计学差异(p0.05vs.C组)。②Rac1:C组肌纤维中Rac1表达均匀,主要位于胞质中。M组a部位胞质中Rac1表达量明显减少(p0.01 vs.C组),但b部位胞质中Racl表达量明显增加(p0.01 vs.C组,且p0.01 vs.M组a部位)。③Cdc42:C组肌纤维中Cdc42表达均匀。M组Cdc42表达虽不均匀但M组a、b两部位Cdc42表达量与C组相比均无统计学差异(p均0.05)。结论:Rho/ROCK及Rac1(而非Cdc42)可能通过Ca2+敏感性机制参与MTrPs肌小节异常收缩的调节,但其具体病理生理机制仍待进一步研究。
[Abstract]:Background and objective: myofascial trigger (MTrPs) is the key etiological mechanism and clinical therapeutic target of myofascial pain syndrome (MPS), mostly located on the involved skeletal muscle cord or sclerosis. Histopathologically confirmed that MTrPs are composed of abnormal contractile muscle segments. However, the mechanism of abnormal contraction in muscle section is still unclear. Rho GTP enzyme and downstream kinase ROCK play an important role in the maintenance of smooth muscle contraction through the mechanism of Ca2 sensitivity. The mechanism of skeletal muscle contraction should be similar to that of smooth muscle. Therefore, we speculated that Rho GTP enzyme Rho.Racl.Cdc42 and ROCK may play an important regulatory role in the sustained abnormal contraction of MTrPs muscle. The purpose of this study was to observe the expression of Rho Rac1CDc42 and ROCK in MTrPs and its adjacent muscles. Methods:. Twenty patients with MPS with MTrPs in trapezius muscle and 10 patients with cervical vertebra operation without MTrPs were selected as control group C, and 20 patients with MPS in trapezius muscle were selected as control group, and the biopsy needle was located on the trapezius muscle of M group. The histomorphological changes of the trapezius muscle in group C were observed by biopsy, HE and Masson staining, and the expression of ROCK2 and CDc42 were detected by immunohistochemical method. Results: in the longitudinal section of group C, the muscle sections of group C were arranged neatly and evenly. The transverse stripe spacing of 1. 91 ~ 0. 19 渭 m. M group was 0. 71 ~ 0. 32 vs.C group (P < 0. 01), and the transverse striation distance was 2. 33 ~ 0. 31 ~ 0. 31 渭 m / m vs.C group p 0. 01 vs.M group (P 0. 01 vs.M group). In the middle of transverse section, the muscle of C group and M group were divided into two groups: group C and group M (P 0. 01 vs.M group), the transverse stripe spacing was 2. 33 ~ 0. 31 ~ 0. 31 vs.C group (p 0. 01 vs.M group). The mean diameters of fibers were 37.37 卤3.72um and 82.61 卤19.48um respectively. Masson staining showed red staining in group C and M, respectively. There was slight blue staining in the muscle fibers, but there was no blue staining on the muscle fibers. The positive expression of RHA-C and ROCK2 in the Rho and ROCK:C groups was uniform by immunohistochemistry. Compared with group C, the expression of Rho and ROCK2 in the cytoplasm of group M was significantly decreased, but the expression of Rho and ROCK2 was found in the membrane and peripheral cytoplasm of group M, and the expression of Rho and ROCK2 was observed in part a of group M. The expression of Rho and ROCK2 in the cytoplasm of the adjacent sarcomere elongated area (B) increased relatively, but there was no significant difference between group C and group C in the expression of Rac1 in muscle fiber of group C (p0.05vs.2Rac1: C), and the expression of Rac1 in muscle fiber of group C was uniform, and the expression of Rac1 in muscle fiber of group C was higher than that of group C (P 0.05 vs.C). The expression of Rac1 in cytoplasm of group A was significantly decreased in group A, but the expression of Racl in cytoplasm in group b was significantly increased in group B (P 0.01 vs.C), but the expression of Racl in cytoplasm was significantly increased in group B (P < 0.05). The expression of Cdc42 in group A was uneven, but there was no significant difference in the expression of Cdc42 between group A and group C (P < 0.05). Conclusion the results suggest that the expression of Cdc42 in the muscle fibers of group A and C may be by Ca2 sensitive machine, instead of Cdc42, and the expression of Cdc42 in group A and C is similar to that in group C (P < 0.01), but there is no significant difference in the expression of Cdc42 between group A and group C (P > 0.05). To participate in the regulation of abnormal contraction of MTrPs muscle. However, its pathophysiological mechanism still needs further study.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R686

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