慢性阻塞性肺病中AQP4mRNA的表达变化及与气道炎症的相关研究.doc

慢性阻塞性肺病中AQP4 mRNA的表达变化及与气道炎症的相关研究 　　者：朱柏,杨岚,陈天君　　作者单位：西安交通大学医学院第一附属医院呼吸内科，陕西西安 　　【摘要】目的 探讨水通道4(apuaporin 4, AQP4)mRNA在慢性阻塞性肺病(COPD)的表达及对气道慢性炎症的影响和意义。方法 选取因各种原因行支气管镜检查被病理学家证实为正常支气管黏膜者及慢性阻塞性肺病患者各30例，分别为正常组及COPD组。测试肺功能，并行支气管镜检，所取黏膜标本用逆转录PCR法检测mRNA表达，HE染色观察支气管黏膜炎症细胞浸润程度。结果 与正常对照组相比较，COPD组患者支气管黏膜AQP4 mRNA表达减少(P0.05)，并和炎症程度负相关(r=-0.493，P0.01)，与FEV1/FVC、FEV1/pred%呈正相关(r分别为0.405、0.461，P均0.01)。结论 COPD患者水通道mRNA表达减低，将影响气道湿化功能，加重气道炎症，促使COPD发生发展。 　　【关键词】 慢性阻塞性肺病,水通道,气道炎症 　　ABSTRACT: Objective To explore the effect and significance of AQP4 mRNA expression in bronchial epithelium of chronic obstructive pulmonary disease (COPD) on airway inflammation. Methods Bronchial epithelium was obtained by bronchoscopy in patients with COPD (n=30) and healthy controls (n=30) whose bronchial epithelium was confirmed to be normal by the pathologist. AQP4 mRNA were studied by RTPCR method. Inflammatory cells infiltration was observed by HE staining; pulmonary function test was performed too before bronchoscopy. Results Compared with that in the healthy controls, AQP4 mRNA expression in COPD was reduced (P0.05). Furthermore, AQP4 mRNA expression was correlated negatively with the inflammation of bronchial epithelium (r=-0.493, P0.01), and correlated positively with FEV1/FVC, FEV1/pred% (r was 0.405 and 0.461 respectively, P0.01). Conclusion The reduced expression of AQP4 mRNA in bronchial epithelium of patients with COPD reduced the airway humidification, aggravated the airway inflammation, and contributed to the development of COPD. 　　KEY WORDS: chronic obstructive pulmonary disease; aquaporin; airway inflammation 　　气道水转运特性对于吸入气体的湿化和维持气道表面液层的容积和组成具有重要作用，气道表面液层的容积和组成异常在一些气道疾病如哮喘和支气管炎的发病中起重要作用。本研究检测了水通道4(aquaporin, AQP4)mRNA在慢性阻塞性肺病患者和正常支气管对照者的支气管黏膜中的表达，以探讨AQP4与气道慢性炎症的关系及在COPD发病中的作用。 　　1 对象与方法 　　1.1 研究对象 　　正常对照组选取因各种原因行支气管镜检查被病理学家证实为正常支气管黏膜者，共30例，年龄25-73岁，平均(53.33±11.51)岁。其中男性18例，女性12例。慢性阻塞性肺疾病组(COPD组)选取符合中华医学会呼吸分会慢性阻塞性肺疾病学组颁布的慢性阻塞性肺疾病的诊治指南标准的COPD患者30例，年龄35-71岁，