Dll4/Notch1在消化道血管发育不良出血患者中的表达以及沙利度胺的干预机制  

Expressions of Dll4/Notchl in Patients with Angiodysplasia-related Gastrointestinal Bleeding and Interventional Mechanism of Thalidomide

作　　者：谭红红[1] 戈之铮[1] 高云杰[1] 陈慧敏[1] 陈海英[1] 房静远[1] 刘文忠[1] 萧树东[1] 

机构地区：[1]上海交通大学医学院附属仁济医院消化内科上海市消化疾病研究所

出　　处：《胃肠病学》2010年第11期646-649,共4页Chinese Journal of Gastroenterology

基　　金：上海市重点学科建设项目资助(Y0205)

摘　　要：DII4／Notch1信号通路是肿瘤血管形成、血管发育等领域的研究热点．然而其在消化道血管发育不良（AGD）中的作用机制尚未阐明。沙利度胺常用于治疗AGD所致的消化道出血。目的：探讨DII4／Notch1信号通路在消化道AGD形成中的作用以及沙利度胺的干预机制。方法：收集不明原因反复消化道出血、经胶囊内镜和（或）小肠镜检查确诊为AGD的患者25例和因AGD致消化道出血接受沙利度胺（100mg／d．疗程4个月）治疗者10例，18名健康志愿者作为正常对照。以ELISA法检测血清DII4、Notchl浓度。结果：AGD组血清DII4、Notch1浓度显著高于正常对照组（P〈0．01），且DII4与Notch1间呈正相关（r=0．900，P〈0．01）。沙利度胺治疗前后，AGD患者的血清DII4、Notch1浓度无明显改变；根据性别和疗效进行分层分析，差异亦无统计学意义。结论：DII4／Notch1信号通路可能参与了消化道AGD的形成．沙利度胺对该信号通路的调节作用不明显．Background： DII4/Notchl pathway is a hot spot of study on tumor angiogenesis and vaseulature development, however, their role in gastrointestinal angiodysplasia （AGD） has not been fully understood. Thalidomide can be used for the treatment of AGD-related bleeding in gastrointestinal tract. Aims： To study the role of DII4/Notchl pathway in gastrointestinal AGD and the interventional mechanism of thalidomide. Methods： Twenty-five patients with recurrent AGD-related gastrointestinal bleeding diagnosed by capsule endoscopy and/or enteroscopy, 10 AGD-related gastrointestinal bleeding patients treated with thalidomide （100 mg/d, 4 months） and 18 healthy volunteers served as controls were enrolled. ELISA method was used to assess the serum DII4 and Notchl levels. Results： Serum levels of DII4 and Notchl in AGD group were significantly higher than that in the control group （P〈0.01） and the level of DII4 was positively correlated with the level of Notchl （r=0.900, P〈0.01）. No significant difference was found in serum levels of DII4 and Notchl before and after thalidomide treatment, even when stratified by gender and efficacy. Conclusions： DII4/Notchl pathway might be involved in the formation of gastrointestinal AGD, however, thalidomide has no significant effect on the regulation of DII4/ Notchl pathway.

关 键 词：血管发育不良 胃肠出血 受体 Notch1 Delta—Like配体4 沙利度胺 治疗 

分 类 号：R57[医药卫生—消化系统]