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目的观察日本血吸虫病传播阻断后人大肠纤维化胶原蛋白和细胞因子的改变。方法在日本血吸虫病传播阻断达标10年地区收集102例血吸虫感染患者大肠标本,在组织切片上进行Ⅰ~Ⅳ型胶原蛋白以及转化生长因子β1(TGFβ1)、碱性纤维母细胞生长因子(bFGF)、基质金属蛋白酶-1(MMP-1)和基质金属蛋白酶组织抑制剂-1(TIMP-1)的免疫组化染色和定量分析。收集同期51例无血吸虫感染者大肠标本作对照。结果102例血吸虫感染患者大肠肠壁内虫卵均已死亡和钙化。26份标本(25.5%)在死亡和钙化虫卵周围发现肉芽肿反应。虫卵高密度组(>60个/mm2)大肠的Ⅰ~Ⅲ型胶原平均吸光度(A)值均较对照组增高,而Ⅳ型胶原平均A值下降。Ⅰ~Ⅲ型胶原平均A值的增加均与肉芽肿反应呈正相关。血吸虫感染大肠肉芽肿组的TGFβ1、bFGF和MMP-1的平均A值分别高于对照组,而TIMP-1的A值低于对照组。结论参与日本血吸虫性大肠纤维化的胶原蛋白和细胞因子含量与虫卵密度、纤维化时期和有无肉芽肿反应有关。
Objective To observe the changes of human colorectal fibrosis collagen and cytokines after schistosomiasis transmission in Japan. Methods Totally 102 cases of schistosomiasis were collected from patients infected with schistosomiasis for 10 years. The type Ⅰ ~ Ⅳ collagen, transforming growth factor β1 (TGFβ1), basic fibroblast growth factor (bFGF) ), Matrix metalloproteinase-1 (MMP-1) and tissue inhibitor of metalloproteinase-1 (TIMP-1) immunohistochemical staining and quantitative analysis. Collected 51 cases of non-schistosomiasis infected patients with large intestine as a control. Results 102 cases of schistosomiasis patients with large intestine intestinal worm eggs have died and calcification. Twenty-six specimens (25.5%) showed granulomatous reaction around dead and calcified eggs. The average absorbance (A) values of type Ⅰ ~ Ⅲ collagen in the high density group (> 60 / mm2) of the eggs were higher than those in the control group, while the average value of type A collagen was decreased. The average A value of type Ⅰ ~ Ⅲ collagen increased with the granuloma reaction was positively correlated. The mean A value of TGFβ1, bFGF and MMP-1 in schistosomiasis-infected colo-granuloma group was higher than that in control group, while the A value of TIMP-1 was lower than that in control group. Conclusion The contents of collagen and cytokines involved in Schistosoma japonicum fibrosis are related to egg density, fibrosis stage and granulomatous reaction.