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目的研究原发性干燥综合征(primarySj觟gren’ssyndrome,pSS)患者唇腺组织上皮细胞凋亡及相关基因表达与pSS组织损伤的关系。方法应用原位末端标记及免疫组织化学的方法,对30例pSS患者及10例对照唇腺组织中凋亡细胞及Fas、FasL、Bc1-2相关基因蛋白的表达进行检测和组织细胞定位。结果pSS患者唇腺组织中腺泡上皮细胞(AEC)及导管上皮细胞(DEC)凋亡率均明显高于对照组(P<0.001),而浸润的单核细胞(IMC)凋亡率与对照组相比差异无显著性(P>0.05)。pSS患者唇腺AEC、DEC及IMC中,Fas阳性表达的细胞百分比均明显高于对照组(P<0.001),并与细胞凋亡率呈正相关(r=0.431,0.415,0.804;P<0.05);FasL阳性表达的细胞百分比均明显高于对照组(P<0.001),并与细胞凋亡率呈正相关(r=0.654,0.619,0.489;P<0.01);Bcl-2阳性表达的细胞百分比,AEC和DEC均明显低于对照组(P<0.05),而IMC明显高于对照组(P<0.001),DEC和IMC与细胞凋亡率呈负相关(r=-0.400,-0.364;P<0.05),但AEC与细胞凋亡率无相关性(r=-0.329,P>0.05)。结论pSS患者唇腺组织中上皮细胞凋亡增加和淋巴细胞凋亡减少可能是导致腺体破坏进而功能丧失的原因之一;Fas、FasL增加及Bcl-2减少皆与促进细胞凋亡有关;Bcl-2在pSS唇腺IMC中表达增加暗示IMC似乎逃脱凋亡,形成炎性浸润灶。
Objective To study the relationship between the apoptosis of oral labial gland epithelial cells and the expression of related genes and pSS tissue injury in patients with primary Sjögren’s Syndrome (pSS). Methods The expression of Fas, FasL and Bcl-2-related genes in 30 pSS patients and 10 control labial gland tissues were detected by in situ end labeling and immunohistochemistry. Results The apoptotic rates of acinar epithelial cells (AECs) and ductal epithelial cells (DECs) in the labial gland of patients with pSS were significantly higher than those in the control group (P <0.001). However, the apoptosis rate of infiltrating mononuclear cells (IMC) There was no significant difference between the two groups (P> 0.05). The percentage of Fas positive cells in the pituitary gland AEC, DEC and IMC in pSS patients was significantly higher than that in the control group (P <0.001), and positively correlated with the apoptosis rate (r = 0.431,0.415,0.804; P <0.05) ; The percentage of cells with positive FasL expression was significantly higher than that of the control group (P <0.001), and positively correlated with the apoptosis rate (r = 0.654,0.619,0.489; P <0.01); the percentage of cells with positive expression of Bcl- AEC and DEC were significantly lower than those in control group (P <0.05), and IMC was significantly higher than that in control group (P <0.001). There was a negative correlation between DEC and IMC and apoptosis rate (r = -0.400 and -0.364, P < 0.05). However, there was no correlation between AEC and apoptosis rate (r = -0.329, P> 0.05). Conclusions The increased apoptosis of epithelial cells and the decrease of lymphocyte apoptosis in labial gland of pSS patients may be one of the reasons leading to the loss of gland function. The increase of Fas and FasL and the decrease of Bcl-2 are related to the promotion of apoptosis. Bcl -2 expression in the pSS labial gland IMC suggests that IMC appears to escape apoptosis and form an inflamed foci.