慢性硬化性涎腺炎的临床病理分析及建立MDP诱导的慢性硬化性涎腺炎样动物模型

发布时间：2018-01-16 22:03

本文关键词：慢性硬化性涎腺炎的临床病理分析及建立MDP诱导的慢性硬化性涎腺炎样动物模型　出处：《吉林大学》2015年硕士论文　论文类型：学位论文

【摘要】：研究目的：探讨总结慢性硬化性涎腺炎（Chronic Sclerosing Sialadenitis, CSS）的临床病理特征，并尝试建立胞壁酰二肽（Muramyl Dipeptide, MDP）诱导的CSS样动物模型。研究方法： 1.回顾性分析诊断2005年01月至2014年01月在吉林大学口腔医院进行治疗的64例慢性涎腺炎患者，通过组织标本的IgG及IgG4免疫组织化学染色，从中筛选出符合慢性硬化性涎腺炎13例，作为实验组，51例非特异性慢性涎腺炎作为对照组，并对两组的临床病理表现进行回顾性对比分析以及CD68免疫组织化学染色分析； 2.应用免疫佐剂与MDP混合注射入实验组大鼠右侧的下颌下腺中，对照组大鼠的右侧下颌下腺被注入免疫佐剂与PBS混合物，两组均每周注射一次，分别注射4周、6周、8周后，取大鼠外周血进行血常规分析及ELISA分析，并将大鼠灌流处死，取其双侧下颌下腺、腮腺及胰腺进行组织固定包埋，切片进行组织学分析。研究结果： 1.两组之间在年龄和性别上无显著差异。CSS组：大部分患者均因无痛性单侧或双侧涎腺肿物就诊。4例患者存在涎腺以外器官受累（1例胰腺，3例泪腺），组织学以富含浆细胞及淋巴细胞浸润的纤维增生为主要特征，且其中11例可见拥有花形等不规则形状生发中心的淋巴滤泡增生，大量CD68阳性细胞弥漫性浸润。对照组：患者因涎腺反复肿痛就诊，没有患者存在涎腺以外器官受累，组织学表现为多种炎细胞浸润，，以及少或无细胞浸润的纤维增生。除一例外，其余病例中增生的淋巴滤泡中的生发中心均形态规则，部分病例可见CD68阳性细胞浸润。 2.实验组与对照组的大鼠右侧下颌下腺体积均增大。实验组大鼠4周后即出现外周血内单核细胞百分比升高（与对照组相比P0.05），8周后更是明显高于对照组（P0.01）；而8周后对照组大鼠外周血内的淋巴细胞百分比则高于实验组（P0.05）。实验组大鼠8周后血清中IgG1浓度明显高于对照组（P0.05），而对照组大鼠8周后的血清中IgG2b浓度高于实验组（P0.05）。从4周开始，实验组大鼠双侧下颌下腺中可见纤维化增生及炎细胞浸润的表现。尤其是左侧下颌下腺，与对照组相比出现更明显的炎性改变。研究结论： 1.CSS在临床表现上与非特异性慢性涎腺炎差别不大，病理组织学上以淋巴细胞、浆细胞浸润和纤维化为主要特征，但诊断仍需借助IgG4及IgG的免疫组化染色。 2.巨噬细胞在CSS病理发展中具有一定的作用。 3.MDP免疫后的大鼠可出现类似于人CSS的临床病理表现，MDP可能在CSS发病机制的初始阶段扮演一定角色，可能与促进单核巨噬细胞系统参与异常固有免疫应答相关。通过MDP诱导可建立一种CSS样动物模型。
[Abstract]:The purpose of the study is:
Objective to summarize the clinicopathological features of Chronic Sclerosing Sialadenitis (CSS) and try to establish a CSS like animal model induced by Muramyl Dipeptide (MDP) two Muramyl.
Research methods:
1. a retrospective analysis of diagnosis of 64 cases of chronic sialadenitis patients treated in Stomatology Hospital of Jilin University from 2005 01 to 2014 01 months, by IgG and IgG4 immunohistochemical staining of tissue samples, were screened with chronic sclerosing sialadenitis in 13 cases, as the experimental group, 51 cases of nonspecific chronic sialadenitis as control group, and the clinical and pathological manifestations of the two groups were retrospectively analyzed and CD68 immunohistochemical analysis;
2. application of adjuvant mixed with MDP injection into the right experimental group rat submandibular gland in control group rat right mandibular gland was injected into the adjuvant mixture with PBS, two groups were injected once a week, were injected for 4 weeks, 6 weeks, 8 weeks later, the rats of peripheral blood. Blood routine analysis and ELISA analysis, and the rats were perfused, the submandibular gland, parotid gland and pancreas tissues were fixed and embedded, sliced for histological analysis.
The results of the study:
Between 1. and two groups in age and gender have no significant difference in group.CSS: most of the patients with painless unilateral or bilateral salivary gland tumor treatment.4 patients exist outside of salivary gland organ involvement (1 cases of pancreas, 3 cases of lacrimal gland), histological fibrosis in plasma cells and lymphocytes as the main feature, and 11 of them cases have visible flower shape irregular germinal center follicular hyperplasia, diffuse infiltration of a large number of CD68 positive cells. Control group: Patients with salivary gland swelling repeated treatment, no patients with salivary gland outside organ involvement, histological appearance for a variety of inflammatory cell infiltration, and little or no cell infiltration in fiber hyperplasia. One exception, the remaining cases of hyperplasia of lymphoid follicles in the germinal center of all morphological rules, some cases showed CD68 positive cell infiltration.
2. the experimental group and control group rat right mandibular gland volume increased. Experimental rats 4 weeks after emergence in peripheral blood mononuclear cells were significantly increased (compared with the control group, P0.05) after 8 weeks was significantly higher than the control group (P0.01); and the control group after 8 weeks of lymphocyte percentage the peripheral blood of rats in the experimental group was higher than that in serum (P0.05). After 8 weeks, the concentration of IgG1 in the rats of experimental group was significantly higher than the control group (P0.05), and control the concentration of IgG2b in serum after 8 weeks rats than in experimental group (P0.05). From the beginning of the 4 week, fibrosis and inflammatory hyperplasia the performance of cell infiltration in rats under the experimental mandibular gland. Especially in the left submandibular gland, compared with the control group had more obvious inflammatory changes.
The conclusions are as follows:
1.CSS has little difference in clinical manifestation with non-specific chronic sialositis. The main characteristics of lymphocytic, plasma cell infiltration and fibrosis are still in histopathology. However, IgG4 and IgG immunohistochemical staining is still needed for diagnosis.
2. macrophages have a certain role in the pathological development of CSS.
3.MDP immunized rats can appear similar to the clinical and pathological manifestations of CSS and MDP may play a role in the initial stage of CSS pathogenesis, and may promote the mononuclear macrophage system involved in innate immune responses induced by abnormal. We can establish a kind of animal model by CSS MDP.

【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R781.72

【相似文献】