Toll样受体在重症肌无力患者胸腺组织中的表达及其临床意义  

Expression of Toll-like receptors in thymus of myasthenia gratis patients

作　　者：高珂[1] 王英成[2] 马小红[2] 李涛[2] 伍贮[1] 刘伦旭[1] 车国卫[1] 寇瑛莉[1] 黄颐[2] 王允[1] 

机构地区：[1]四川大学华西医院胸心外科,成都610041 [2]四川大学华西医院心理卫生中心,成都610041

出　　处：《中华医学遗传学杂志》2008年第3期311-314,共4页Chinese Journal of Medical Genetics

基　　金：国家自然科学基金（30100181、30570654）;四川大学青年科技基金（2003035）

摘　　要：目的研究Toll样受体（Toll-like receptor，TLRs）在重症肌无力（myasthenia gravis，MG）患者胸腺组织中的表达，分析其与MG发生、发展的关系。方法收集我科2007年7月至2008年2月手术治疗的36例MG患者胸腺标本，分为胸腺瘤组、瘤旁胸腺组、非瘤MG胸腺组，以无MG的正常胸腺21例为对照（正常胸腺组），采用逆转录-PCR技术，检测TLR2、TLPO、TLR4在胸腺组织中的mRNA转录表达水平，进一步采用实时定量逆转录-PCR检测TLR4 mRNA转录表达水平以及与MG临床特点间的关系。结果逆转录-PCR结果显示，TLR2 mRNA和TLPO mRNA在4组之间的差别没有统计学意义，TLR4 mRNA的表达在4组之间的差别有统计学意义。进一步的实时定量逆转录-PCR检测TLR4 mRNA转录表达的结果显示，瘤旁胸腺组的TLR4 mRNA的表达比胸腺瘤组有明显的增加（0．8214±0．1019vs0．7101±0．0916，P=0、005），非瘤MG胸腺组TLR4 mRNA的表达量比正常胸腺组明显增加（0．8544±0．1200vs0．6851±0．1524，P=0．018），瘤旁胸腺组和非瘤MG胸腺组TLR4 mRNA的表达量之间的差别没有统计学意义，且都比正常胸腺组明显增加；TLR4 mRNA的表达与患者的Osserman分型呈正相关（R=0．609；P=0．004）。结论TLR4异常表达可能在MG发病中有重要作用，MG合并胸腺瘤患者瘤旁胸腺组织中TLR4的表达状态对胸腺瘤患者是否并发MG可能有重要影响。Objective To investigate the expression of Toll-like receptors （TLRs） in thymus of myasthenia gravis （MG） patients and the relationship with clinical features. Methods Thymie specimens of 36 patients received extended thymeetomy for MG were divided into three groups by pathological type： 13 thymoma tissues （thymoma group） and 13 thymie tissues adjacent to thymomas （parathymoma group） from 13 eases of MG patients with thymomas, and 23 thymie tissues from MG patients without thymomas （MG nonthymoma group）. Twenty-one normal thymie specimens from cardiac surgery were used as controls. The levels of TLR2-4 mRNA were examined by RT-PCR, then the levels of TLR4 mRNA were assayed by real time RT-PCR and their relationship with clinical features were analyzed. Results The levels of TLR4 mRNA among the different groups had significant differences, while there was no difference in TLR2 and TLR3 levels. The real time RT-PCR showed that the level of TLR4 mRNA in nonthymoma group was significantly higher than that in control group（0. 8544 ± 0. 1200 vs 0. 6851 ± 0. 1524, P = 0. 018）. And so is parathymoma group compared with the thymoma group （0. 8214 ±0. 1019 vs 0. 7101 ± 0.0916, P = 0.005）. No significant difference of TLR4 mRNA level was found between the parathymoma and nonthymoma groups. Nevertheless, the expression of TLR4 in both groups was increased compared with control group. The levels of TLR4 mRNA had positive correlation with Osserman type（R = 0. 609; P = 0. 004）. Conclusion TLR4 may play a key role in the pathogenesis of MG. It was the thymic tissues adjacent to thymomas but not thymomas themselves participated in the onset of MG.

关 键 词：重症肌无力 胸腺 TOLL样受体 

分 类 号：R686[医药卫生—骨科学]