杀菌/通透性增强蛋白对分泌性中耳炎模型大鼠损伤黏膜的修复作用  

Reparative effect of BPI on damaged mucosa of rats with experimental otitis media with effusion

作　　者：房宁[1] 汪欣[1] 祝威[1] 

机构地区：[1]吉林大学第一医院耳鼻咽喉-头颈外科,吉林长春130021

出　　处：《吉林大学学报（医学版）》2009年第6期1015-1019,F0002,共6页Journal of Jilin University：Medicine Edition

基　　金：吉林省科技厅科研基金资助课题(200505187)

摘　　要：目的:探讨杀菌/通透性增强蛋白(BPI)对分泌性中耳炎(OME)损伤黏膜的修复作用,阐明OME的发病机理。方法:Wistar大鼠(40耳)随机分为正常对照组(4耳)、BPI对照组(4耳)、咽鼓管阻塞(ETO)组(8耳)、内毒素(LPS)注射组(8耳)、ETO+LPS组(8耳)及ETO+LPS+BPI组(8耳),通过咽鼓管阻塞和中耳腔注射LPS制备OME动物模型,在动物模型制备后第1、2和4周分别处死动物,光镜和扫描电镜观察中耳黏膜的变化。结果:正常对照组、BPI对照组大鼠的中耳黏膜保持正常形态,在咽鼓管的鼓室口处可见较多的假复层立方或柱状上皮细胞,这些上皮细胞含有较多的纤毛细胞和少量杯状细胞,构成大鼠中耳粘液纤毛输送系统;上鼓室处的黏膜由单层、扁平鳞状上皮细胞和少量微绒毛构成,细胞界限清楚,呈多边形,纤毛细胞数量较咽鼓管鼓室口处明显减少。LPS注射组、ETO组、ETO+LPS组大鼠中耳黏膜明显增厚,在咽鼓管鼓室口可见纤毛细胞减少、杯状细胞增多,同时在上鼓室上皮层观察到数量较多的假复层立方上皮细胞。而ETO+LPS+BPI组大鼠为近似正常的中耳黏膜,上鼓室处的黏膜为单层鳞状上皮细胞和少量微绒毛。结论:LPS和ETO通过中耳黏膜的炎症反应削弱黏液纤毛输送系统的功能,导致OME的发生和迁延。BPI与LPS有特异的亲和作用,抑制LPS导致的炎症反应,恢复有效的黏液纤毛输送系统,而对正常黏膜没有损伤,是一种潜在的治疗和预防慢性中耳炎的有效药物。Objective To explore the reparative effect of bactericidal/permeability-increasing protein（BPI） on the damaged mucosa of rats with otitis media with effusion （OME）,and state the pathogenesis of OME.Methods Wistar rats（40 ears） were randomly divided into six groups：normal control group （n=4）,BPI control group（n=4）,eustachian tube obstruction （ETO） group （n=8）,lipopolysaccharide （LPS） injection group （n=8）,ETO＋LPS group （n=8）,ETO＋LPS＋BPI group （n=8）.The experimental OME model was made through eustachian tube obstruction and LPS injection.The rats were killed after 1,2 and 4 weeks and the changes of mucosa of middle ear were observed under light and scanning electron microscope.Results The rats in normal control group and BPI control group had the normal mucosa in the tympanic orifice of the eustachian tube.It consisted of pseudostratified ciliated cubical or columnar epithelium which contained an abundant number of ciliated cells and a few goblet cells,these were the mucociliary clearance system of the middle ear.The hypotympanum consisted of thin,squamous epithelium with few microvillus.Middle ear mucosa was obviouly thickened in LPS injection,ETO and ETO＋LPS groups.An increase in goblet cells and a decrease in ciliated cells were observed in the tympanic orifice of the eustachian tube.The epithelial layer in the hypotympanum had become more pseudostratified ciliated cubical epithelium.In ETO＋LPS＋BPI group,there was thin squamous epithelium in the hypotympanum near normal,which was not thickened and contained few microvillus. Conclusion LPS and ETO can result in the occurrence and protracted courses of OME by mimosa＇s inflammatory reaction which can reduce the activity of ciliary cells and weaken the function of mucociliary clearance system.BPI could bind avidly to LPS,reduce inflammatory reaction,and break the inflammatory cycle and reestablish an effective mucocillary clearance system.The results suggest that BPI treatment is a potential effective drug

关 键 词：杀菌/通透性增强蛋白 内毒素 中耳炎 伴渗出液 咽鼓管阻塞 

分 类 号：R764.21[医药卫生—耳鼻咽喉科] R-332[医药卫生—临床医学]