全髋关节成形术后细胞因子的基因表达：手术部位与循环系统中中性粒细胞应答的比较  

作　　者：Asokumar Buvanendran, MD Kendall Mitchell, PhD Jeffrey S. Kroin, PhD Michael J. Iadarola, PhD 杨丽娜(译) 刘晓(译) 郭曲练(校) 

机构地区：[1]Deparmlent of Anesthesiology, Rush University Medical Center, Chicago, Illinois [2]Neurobiology and Pain Therapeutics Section, National Institute of Dental and Craniofacial Research, NIH, Bethesda, Maryland [3]不详

出　　处：《麻醉与镇痛》2011年第4期88-93,共6页Anesthesia & Analgesia

摘　　要：背景外科手术结束后，细胞因子和趋化因子都会在手术部位释放，这些因子与手术后疼痛、局部炎症反应和组织修复有关。目前发现多种类型的细胞能够在手术部位释放细胞因子或趋化因子，但这些因子的确切来源尚不清楚，因此，我们对全髋关节成形术（THA）后早期中性粒细胞对手术部位细胞因子或趋化因子基因表达的影响进行了研究：方法全髋关切成形术前，收集6例患者的静脉血并在手术后24小时时收集髋关节引流液和静脉血，然后分离中性粒细胞，提取总RNA，合成生物素cRNA探针，将该探针与cDNA微点阵杂交，该微点阵包含了大约100个能够代表不同人类细胞因子、趋化因子或其受体基因的寡核苷酸序列。微点阵上显示的基因表达的变化可以通过逆转录聚合酶链反应证实。结果髋关节引流涂中的中性微细胞微点阵分析结果表明，白细胞介素1受体拮抗剂（IL1RN）、白细胞介素18受体1（IL18R1）、巨噬细胞迁移抑制因子（MIF）和巨噬细胞炎症蛋白3（CCL20）上调，而白细胞介素8受体β（IL8RB／CXCR2）与术前相比是持续下调。所有的这些改变都可以通过逆转录聚合酶链反应证实。结论与THA术前的循环系统中性粒细胞相比，手术后24小时时在手术部位的中性粒细胞会有显著的细胞因子基因表达。了解这些变化可以让我们通过调控中性粗细胞的活性来减少手术后疼痛和炎症反应，而不影响作品的愈合。BACKGROUND： After surgery, cytokines and chemokines are released at the surgical wound site, which can contribute to postoperative pain, local inflammation, and tissue repair. Multiple cell types are present that can release cyto kines/chemokines at the wound site and, thus, the exact cellular source of these molecules is unclear. We sought to better understand the contribution of neutrophils to cytokine/chemokine gene expression at the surgical wound site during the initial postsurgery phase of total hip arthroplasty （THA）. METHODS： Hip drain fluid was collected at 24 h postsurgery from six patients undergoing standardized THA. In addition, venous blood was collected presurgery and 24 h postsurgery. Neutrophils were isolated, total RNA extracted, and a biotinylated cRNA probe generated. The probes were hybridized with a cDNA microarray containing approximately 100 oligonudeotide sequences representing various human cytokines/chemokines or receptor genes. Changes in gene expression seen in the microarray were verified by reverse transcription polymerase chain reaction. RESULTS： In the microarray analysis of hip drain neutrophils, interleukin-1 receptor antagonist （IL1 RN）, interleukin- 18 receptor 1 （IL18R1）, macrophage migration inhibitory factor （MIF）, and macrophage inflammatory protein 3α （CCL20） were upregulated, whereas interleukin-8 receptor β （IL8RB/CXCR2） was consistently downregulated, compared with presurgery blood neutrophils. All of these changes were confirmed by reverse transcription polymerase chain reaction. CONCLUSIONS： There is a distinct cytokine gene expression profile in neutrophils at the THA surgical wound site at 24 h postsurgery when compared with that found in presurgery circulating neutrophils. Understanding these changes may allow us to knowledgeably manipulate neutrophil activity to reduce postoperative pain and inflammation without impairing wound hcaling.

关 键 词：早期中性粒细胞 全髋关节成形术 手术后疼痛 细胞因子 手术部位 基因表达 细胞应答 循环系统 

分 类 号：R722.6[医药卫生—儿科]