慢性扁桃体炎疾病中IL-4、TNF-α、Foxp3、CTLA-4的表达及临床意义

发布时间：2018-01-24 17:21

本文关键词： 白细胞介素-4 肿瘤坏死因子-α 叉头蛋白转录因子3 细胞毒T淋巴细胞抗原-4 慢性扁桃体炎扁桃体肥大　出处：《安徽医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：研究背景及目的慢性扁桃体炎(chronic tonsillitis,CT)常起因于扁桃体急性炎症反复发作或扁桃体隐窝引流不畅,窝内病毒细菌滋生感染[1]。扁桃体肥大(tonsillar hypertrophy,TH)即腺样体肥大,是发生在咽扁桃体的生理性或病理性的增生肥大,反复炎症刺激、咽部感染、营养不良、急性传染病和体质等是其诱发因素[3],尤其在寒冷、潮湿和气候多变的地区多发。本文研究的对象是慢性扁桃体炎和扁桃体生理性肥大的患者。本研究主要通过检测白细胞介素-4(interleukin-4,IL-4)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、叉头蛋白转录因子-3(forkhead box P3,Foxp3)和细胞毒T淋巴细胞抗原-4(Cytotoxic T-Lymphocyte Antigen 4,CTLA-4)在CT组和TH组扁桃体组织中的表达差异与分布特征,并探讨他们在CT发病发展过程中可能发挥的免疫学作用和机制。方法从安徽医科大学第一附属医院耳鼻咽喉头颈外科接受扁桃体全切术的患者中收取CT患者扁桃体标本35例为实验组,TH患者扁桃体标本23例为对照组。用HE染色法观察两组扁桃体组织的病理改变,用免疫组化实验检测IL-4、TNF-α、Foxp3在两组扁桃体组织中的表达差异与分布特征,用免疫荧光技术检测CTLA-4在两组扁桃体组织中的表达差异和分布特征,用实时荧光定量PCR实验检测IL-4m RNA、TNF-αm RNA、Foxp3 m RNA及CTLA-4 m RNA在两组扁桃体的相对表达定量。结果1)HE染色结果显示CT组扁桃体病理结构以滤泡增生和生发中心的变化为主要特征,TH组发现滤泡增生伴随明显的“星空”现象。2)免疫组化实验结果发现,相对于TH组而言,CT组的IL-4、TNF-α、Foxp3的表达均显著上调。3)免疫荧光结果显示CT组扁桃体组织中CTLA-4的平均荧光强度和密度均明显高于TH组。4)实时荧光定量PCR实验结果显示CT组IL-4m RNA,TNF-αm RNA,Foxp3m RNA和CTLA-4 m RNA的相对表达量显著高于HT组(n=58,t=6.294,t=6.294,P值分别为P0.01,P0.05,P0.0,5,P0.01),差异有统计学意义。结论IL-4、TNF-α、Foxp3及CTLA-4在CT疾病的免疫应答过程中发挥重要的免疫促进或免疫抑制作用,影响CT炎症反应的发生发展。
[Abstract]:Background and objective chronic tonsillitis (CTT) is often caused by recurrent acute inflammation of the tonsillitis or poor drainage of the tonsillar recess. Viral infection in nest. [1. Tonsillar hypertrophy of tonsillar hypertrophy, or adenoid hypertrophy, occurs in the pharyngeal tonsillar hypertrophy, which occurs in the pharyngeal tonsil. Pharynx infection, malnutrition, acute infectious disease and physical constitution are the predisposing factors. [3], especially in cold. The subjects of this study are patients with chronic tonsillitis and physiologic hypertrophy of tonsil. Interleukin-4. IL-4, tumor necrosis factor- 伪 (TNF- 伪). Forkhead box P3. Foxp3) and cytotoxic T-Lymphocyte Antigen 4. CTLA-4) expression and distribution in tonsils of CT and th groups. To explore the immunological role and mechanism they may play in the development of CT. Methods CT patients were collected from patients undergoing total tonsillectomy in otolaryngology and head and neck surgery of the first affiliated Hospital of Anhui Medical University. The tonsils were collected from 35 cases of experimental group. Twenty-three tonsils of th patients were taken as control group. The pathological changes of tonsil tissue were observed by HE staining and IL-4 TNF- 伪 was detected by immunohistochemistry. The expression and distribution of Foxp3 in tonsils of two groups were detected by immunofluorescence technique. The expression and distribution of CTLA-4 in tonsils of two groups were detected by immunofluorescence technique. IL-4m RNAs TNF- 伪 m RNA were detected by real-time fluorescence quantitative PCR assay. Relative quantitative expression of Foxp3 m RNA and CTLA-4 m RNA in tonsils of two groups. Results 1). The pathological structure of tonsil in CT group was characterized by follicular hyperplasia and germinal center. In th group, follicular hyperplasia was found with obvious "starry sky" phenomenon. 2) Immunohistochemical results showed that IL-4 TNF- 伪 in CT group was higher than that in th group. The results of immunofluorescence showed that the average fluorescence intensity and density of CTLA-4 in tonsils of CT group were significantly higher than those of th group. 4). The results of real-time fluorescence quantitative PCR showed IL-4m RNA in CT group. The relative expression of Foxp3m RNA and CTLA-4 m RNA in TNF- 伪 m RNAs was significantly higher than that in HT group. P value was P0.01P0.05P0.05P0.01a, the difference was statistically significant. Conclusion IL-4 TNF- 伪. Foxp3 and CTLA-4 play an important role in the immune response of CT disease and affect the development of CT inflammation.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R766.18

【参考文献】