实验性病毒性心肌炎病程中穿孔素表达水平的变化及其与心肌损害的关系  

Experimental studies on dynamic changes of perforin expression levels and the relationship between the changes and myocardial damages in the development of viral myocarditis

作　　者：熊丁丁[1,2,3] 杨英珍[1,2,3] 胡英[1,2,3] 陈灏珠[1,2,3] 

机构地区：[1]卫生部病毒性心脏病重点实验室 [2]上海市心血管病研究所 [3]上海医科大学中山医院

出　　处：《中华心血管病杂志》1998年第1期21-24,共4页Chinese Journal of Cardiology

基　　金：国家"九五"科技攻关基金

摘　　要：目的探讨病毒性心肌炎（ＶＭＣ）发病过程中，心肌炎症细胞中穿孔素（ＰＦＰ）表达水平的动态变化及其与心肌病变的关系。方法采用半定量ＲＴ－ＰＣＲ及免疫组化方法，检测小鼠ＶＭＣ各时期心肌炎症细胞的ＰＦＰｍＲＮＡ及其抗原表达水平，并检查心肌病理变化及半定量分析其程度，统计学分析ＰＦＰ表达水平的动态变化与心肌病变程度的演变的相关性。结果（１）感染后０～１０天，ＰＦＰｍＲＮＡ及抗原的表达水平逐渐升高，心肌病变以炎症细胞浸润及心肌坏死为主并逐渐加重，１０～１５天ＰＦＰ表达水平最高，上述心肌病变也最严重，２０天以后ＰＦＰ逐渐下降，心肌炎症细胞浸润及坏死逐渐减轻，代之以成纤维细胞增生、胶原纤维沉积及心肌纤维化等；（２）在小鼠心肌炎发病过程中，ＰＦＰ抗原表达水平的变化与心肌病变积分的变化呈显著正相关（ｒ＝０．９５，Ｐ＜０．０５）。结论ＰＦＰ介导的细胞毒作用可能是ＶＭＣ中心肌损害的主要机制之一。Objective To investigate the dynamic changes of perforin expression level in infiltrating lymphocytes in myocardium and the relationship between the changes and myocardial damages in the development of viral myocarditis. Methods Perforin expression levels were determined by semiquantitative RT PCR and immunohistochemistry, and myocardial lesions were observed and myocardial histopathological scores were estimated, in addition, the relationship between the dynamic changes of perforin expression level and the development of myocardial damages was studied statistically. Results (1) From day 0 to 10 after CVB3 infection, the mRNA and antigen expression levels of perforin gradually increased, and myocardial lesions including infiltration of inflammatory cells and myocardial necrosis gradually developed; from day 10 to 15 post infection perforin expression level peaked and the above mentioned lesions also became the most serious; after day 20 post infection, the expression levels of perforin gradually decreased, and myocardial inflammation and necrosis gradually lightened with ingrowth of fibroblasts or collagen. (2)Dynamic changes of perforin expression level showed significantly positive correlation with the changes of myocardial histopathologic scores ( r =0.95, P <0.05). Conclusion Perforin mediated cytotoxicity might play an important role in the development of viral myocarditis.

关 键 词：病毒性心肌炎 穿孔素 心肌损害 T细胞 细胞毒性 

分 类 号：R542.21[医药卫生—心血管疾病]