创伤患者p38MAPK信号通路的变化及其临床意义  

Changes and clinical significance of the signal pathway of p38MAPK in traumatic patients

作　　者：王毅鑫[1] 苏文利[1] 朱文献[1] 孙仲伦[1] 陈奋[1] 金戈[1] 刘宇健[2] 李忆东[2] 

机构地区：[1]上海中医药大学附属普陀医院急救中心,200062 [2]解放军第二军医大学病理生理学教研室,上海200433

出　　处：《中国急救医学》2008年第3期201-204,共4页Chinese Journal of Critical Care Medicine

基　　金：上海市卫生局医学重点专科主攻课题(No05II0182-1)

摘　　要：目的探讨不同创伤程度患者体内p38MAPK信号通路的变化及意义。方法不同创伤程度住院患者150例，根据创伤度评分（ISS）分为三组：ISS≤15分（L-ISS）组、ISS 16～25分（M-ISS组）、ISS≥25分（H-ISS）组，每组50例，同时选取30名健康献血者作为对照组。不同创伤程度患者在创伤后6h内和第1、3、5、7天分别采集外周血，对照组采集外周血一次，采用实时定量PCR（RQ-PCR）和蛋白免疫印迹法（Western-blot）检测白细胞中p38MAPK的基因表达、蛋白表达及活化（磷酸化）水平变化。结果创伤6h内不同创伤程度患者血液中p38MAPK的基因表达与正常人比较均显著增加（P〈0．05），在创伤后第1天达到高峰（P〈0．01），并持续高表达至第7天（P〈0．05）；在创伤后第1天不同创伤程度患者体内的p38MAPK蛋白表达和活化（磷酸化）水平也显著增强（P〈0．05）；进一步的试验发现，p38MAPK的基因表达、蛋白表达和活化（磷酸化）程度都随创伤级别的增加而升高（P〈0．05）。结论创伤患者体内的p38MAPK信号通路被激活，且创伤程度与p38MAPK的表达和活化呈正相关，表明p38MAPK信号通路在创伤的病理机制中发挥重要作用。Objective To investigate the changes of the signal pathway of p38 mitogen - activated protein kinase （p38MAPK） in traumatic patients and their influences. Methods Peripheral blood samples were collected from traumatic patients within 6 hours and on 1st, 3rd, 5th, 7th day, respectively. Real - time quantitative polymerase chain reaction （ RQ - PCR） and Western - blot were used to examine the mRNA and protein levels of p38MAPK and activation of p38MAPK. Results The mRNA level was increased in traumatic patients compared with that in healthy control within 6 hours after injury （ P 〈 0.05 ） , reached the summit at 1 day, and then kept at high level until 7 day. The protein level and activation （ phosphorylation ） of p38MAPK were also increased at 1 day after injury （ P 〈 0.05 ）. Furthermore, the mRNA and protein levels of p38MAPK and activation of p38MAPK were all improved with the increase of injury severity score （ISS） （P 〈0.05）. Conclusion The signal pathway of p38MAPK was activated in traumatic patients, and the severity of trauma was highly correlated with the expression and activation of p38MAPK, which indicated that p38MAPK may play an important role in the pathogenesis of trauma.

关 键 词：创伤 信号通路 P38MAPK 

分 类 号：R641[医药卫生—外科学]