【作者】 倪杰；

【导师】 高下；

【作者基本信息】 南京医科大学 ， 耳鼻咽喉科学， 2009， 硕士

【摘要】 目的水通道蛋白是近年新发现的一组膜蛋白,它在体内液体转运和某些腺体分泌方面具有重要作用。迄今为止,大多数研究仅局限于AQPS与下呼吸道粘膜的关系及意义,AQPS是否在上呼吸道粘膜,尤其是鼻黏膜组织水肿的形成以及腺体分泌中起一定作用,很少见文献报道。本文通过丙酸氟替卡松( FP)对体外原代及传代培养的鼻粘膜上皮细胞和体内鼻息肉组织中水通道蛋白5(AQP5)表达的影响,初步探讨AQP5在鼻息肉病情发展不同阶段中的可能机制。方法1、将人鼻粘膜上皮细胞进行体外原代细胞培养14天,待细胞繁殖传代后,FP组细胞加入丙酸氟替卡松浓度为0.2%的1640完全培养液,非FP组细胞加入不含丙酸氟替卡松的1640完全培养液继续培养,7天后爬片用丙酮固定,采用免疫组织化学技术检测细胞爬片中AQP5的表达。并测定阳性细胞的光密度值和灰度值。2、将12例慢性鼻窦炎鼻息肉患者(均为初发型),三个月内无局部及全身激素使用史,取其鼻息肉组织,术前应用FP喷雾剂喷鼻7d ,治疗7d后于术中再次取其鼻息肉组织,术后病理均证实为鼻息肉组织,采用免疫组化技术检测鼻息肉组织中AQP5的表达和分布。并测定阳性细胞的光密度值和灰度值。结果1、在体外培养的鼻粘膜上皮细胞FP组的水通道蛋白5表达增加,其灰度值明显降低(p<0.05),光度值则升高(p<0.05);配对t检验有统计学意义。2、鼻息肉组织的免疫组化染色显示,AQP5在FP组和非FP组息肉组织中的分布基本一致:主要分布在腺体细胞,淋巴管细胞,上皮细胞及各种炎症细胞中。3、在体内鼻息肉组织中,患者使用FP后鼻息肉体积明显缩小,用药后水通道蛋白5在腺体细胞和淋巴管细胞中表达减少,其灰度值明显升高(p<0.05),光密度值则明显低于使用前(p<0.05)。配对t检验有统计学意义。结论在FP作用下培养的鼻粘膜上皮细胞中的AQP5表达增加,可能解释在体情况下有利于组织间液的排除,减轻鼻粘膜及轻度的鼻息肉的水肿,而在鼻息肉组织中,应用FP后,鼻息肉体积缩小,水肿减轻,可能与AQP5在腺体和淋巴管细胞中表达减少有关,说明AQP5在鼻息肉的形成和发展过程中起到一定的作用,并推测其在鼻息肉的病程的早期和晚期作用机制应该是不同的。更多还原

【Abstract】 ObjectiveAquaporins (AQPs) is a kind of membranous protein found odd-come-shortly,which play an important part in the liquid transfer and some secretory function. So far, a lot of research only studied between AQPs and sub-airway mucosa. There is few paper about the relationship between AQPs and up-airway mucosa’s edema and secretory function, special the nasal mucosa.Our research confirmed the expression and distribution of AQP5 in the two kinds of nasal polyps by immunochemistry. It is to discuss the pathology function of the AQP5 in nasal polyps.MethodsChoose from these inpatients who came into our department to receive nasal polyps resection. AQP5 were studied in 20 samples nasal polyps without AR (Group NAR) and 16 samples with AR (Group AR) with immunochemistric staing, by its integrated light intensity and its grey step.Results1、The grey step of AQP5 in the cells of FP-using group is lower obviously than using FP before(p<0.05),the light intensity is higher obviously than using FP before(P<0.05).2、immunohistochemical staining technique showed that the distribution of AQP5 in the two groups was in accordance with that in nasal polyps on the whole. AQP5 expressed mainly in the glandular cells、lymphocytes、epithelial cells and inflamnatory cells.3、In the nasal polyps of FP-using group,the size of nasal polyps become much smaller than using FP before.The grey step of AQP5 in both glandular cells and lymphocyte is higher obviously than using FP before(P<0.05) but the light intensity is lower obviously than using FP before(P<0.05).Conclusionsthe expressions of AQP5 in cells which treated with FP became higher than cells which untreated,It indicated that when treated with FP,interstitial fluid can effuse easily,the concha nasalis media and the concha nasalis inferior became smaller and smaller. After nasal polyps samples treated with FP,the poloyps became smaller.At the same time,the expressions of AQP5 in glandular cells and lymphocyte became lower .There may be relationship between these.It can indicate that AQP5 contributed to edema of nasal polyps.更多还原