慢性鼻—鼻窦炎患者鼻腔黏膜CD55、CD59的表达及其意义

发布时间：2019-04-22 07:38

【摘要】：背景与目的：慢性鼻-鼻窦炎(chronic rhinosinusitis,CRS)是鼻腔粘膜的慢性炎症，是耳鼻喉科最常见的疾病之一。补体是一组参与炎症及免疫反应发挥一定生物学效应的蛋白，近年来补体活化在慢性鼻-鼻窦炎发病中的作用越来越受到人们重视。补体调节蛋白(complementregulatoryproteins，CRP)可抑制补体活化对自身组织的损伤，在补体调节过程中起着主要的作用，人体血细胞、血管内皮细胞、黏膜上皮细胞等多种组织细胞可表达补体调节蛋白。补体调节蛋白以特定的方式与补体系统的不同成分相互作用，使补体的激活和抑制处于精细的平衡状态，从而防止对宿主自身组织造成损害。其中CD55、CD59是目前在呼吸道粘膜免疫中研究得较多的膜结合CRP。]研究发现鼻息肉患者鼻腔粘膜分泌物中有高浓度的C3a和C5a，提示鼻息肉患者鼻腔粘膜局部也有补体活化，并参与鼻息肉的发病机制中。但对于慢性鼻-鼻窦炎患者CD55和CD59的表达水平尚未见报道。本研究通过观察CD55，CD59在慢性鼻-鼻窦炎组织中的表达。探讨其与慢性鼻-鼻窦炎发病的关系。方法：选取2011年7月至2012年7月行鼻窦内窥镜手术的慢性鼻窦炎患者60例，分为单纯炎症组和合并鼻息肉组，手术切除上颌窦开口处黏膜。并以30例单纯行鼻中隔偏曲矫正手术患者为对照组，对照组粘膜标本来自行鼻中隔手术患者鼻道-窦口复合体黏膜。采用免疫组织化学方法检测三组患者鼻腔黏膜及鼻息肉组织中CD55和CD59的表达情况。结果：CD55和CD59在对照组及鼻窦炎鼻息肉组织中均有表达，二者在对照组的表达高于鼻窦炎鼻息肉组织（P0.05，P0.01）。与单纯炎症组相比，，合并鼻息肉组CD55和CD59表达进一步下降（P0.05）。结论:慢性鼻窦炎鼻息肉患者鼻腔黏膜CD55、CD59的表达降低，提示补体调节蛋白表达下降，进而导致补体活化，可能参与慢性鼻-鼻窦炎发病机制。
[Abstract]:Background & objective: chronic rhinosinusitis (chronic rhinosinusitis,CRS) is a chronic inflammation of nasal mucosa and one of the most common diseases in Otolaryngology. Complement is a group of proteins that play a biological role in inflammation and immune response. In recent years, the role of complement activation in the pathogenesis of chronic rhinosinusitis has been paid more and more attention. Complement regulatory protein (complementregulatoryproteins,CRP) can inhibit the injury of complement activation to its own tissue and play a major role in complement regulation. Human blood cells and vascular endothelial cells play an important role in the process of complement regulation. Many tissue cells, such as mucosal epithelial cells, can express complement regulatory proteins. Complement regulatory proteins interact with different components of the complement system in a specific way, which makes complement activation and inhibition in a fine equilibrium state, thus preventing damage to host tissues. Among them, CD55,CD59 is a membrane-bound CRP. which has been widely studied in respiratory mucosal immunity.] It was found that there were high concentrations of C3a and C5a in nasal mucosa secretions in patients with nasal polyps, suggesting that complement activation was also found in nasal mucosa of patients with nasal polyps and involved in the pathogenesis of nasal polyps. However, the expression of CD55 and CD59 in patients with chronic rhinosinusitis has not been reported. In this study, we observed the expression of CD55,CD59 in chronic rhinosinusitis. To explore the relationship between chronic rhinosinusitis and chronic rhinosinusitis. Methods: 60 patients with chronic sinusitis who underwent endoscopic sinus surgery from July 2011 to July 2012 were divided into two groups: simple inflammation group and nasal polyps group. 30 cases of nasal septum deviation correction were taken as the control group, and the mucosa specimens of the control group were from the nasal meatus-sinus complex mucosa of the patients undergoing nasal septum surgery. Immunohistochemical method was used to detect the expression of CD55 and CD59 in nasal mucosa and nasal polyps. Results: the expression of CD55 and CD59 was higher in the control group than in the sinusitis and nasal polyp tissue (P0.05, P0.01), and the expression of both of them was higher in the control group than in the sinusitis and nasal polyp tissue (P 0.05, P0.01). Compared with simple inflammation group, the expression of CD55 and CD59 decreased further in nasal polyp group (P0.05). Conclusion: the decreased expression of CD55,CD59 in nasal mucosa of patients with chronic sinusitis and nasal polyps suggests that the decreased expression of complement regulatory protein leads to complement activation, which may be involved in the pathogenesis of chronic rhinosinusitis.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R765.41

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