肾综合征出血热循环内皮细胞中黏着斑激酶及热休克蛋白70表达的研究  

Expression of focal adhesion kinase and HSP70 in circulating endothelial cells in hemorrhagic fever of renal syndrome

作　　者：赵秀华[1] 荆燕[1] 王晓花[1] 

机构地区：[1]济南市传染病医院,山东济南250021

出　　处：《中国病毒病杂志》2011年第6期434-438,共5页Chinese Journal of Viral Diseases

基　　金：济南市卫生局立项课题(2008-29)

摘　　要：目的通过检测肾综合征出血热(HFRS)患者循环内皮细胞(CEC)计数及CEC中磷酸化黏着斑激酶(FAKps910)、热休克蛋白70(HSP70)的阳性表达率,了解HFRS患者CEC计数及FAKps910、HSP70表达的动态变化,探讨其临床意义。方法 50例HFRS患者按病情分为轻型17例、中型20例、重型及危重型13例,健康对照组20例。流式细胞技术检测CEC计数及CEC中FAKps910、HSP70的表达情况。结果从发热早期至多尿期,HFRS患者CEC计数[发热早期:(13.37±5.19)个/μl;发热期末或低血压休克期:(47.73±19.89)个/μl;少尿期(41.11±16.21)个/μl;多尿期(19.29±4.81)个/μl]及HSP70的表达水平(发热早期:53.26%±10.54%;发热期末或低血压休克期:56.21%±8.83%;少尿期:40.13%±6.99%;多尿期:28.53%±6.79%)均显著高于对照组[CEC计数:(3.31±1.49)个/μl;HSP70:23.89%±4.70%],至恢复期[CEC计数:(3.86±1.98)个/μl;HSP70:26.52%±6.31%]则逐渐趋向正常。在发热期末或低血压休克期CEC及HSP70随病情加重而升高,在重型和危重型患者中达到高峰。但循环内皮细胞中FAKps910的表达水平在发热早期(59.87%±9.58%)明显升高,发热期末或低血压休克期降至正常水平以下(11.64%±2.17%),以后又恢复正常(少尿期:22.44%±4.09%;多尿期:21.05%±2.61%;恢复期:20.94%±3.15%)。且发热末或低血压期FAKps910的表达随病情加重而减少,在重型和危重型患者中降至最低。结论 HFRS中CEC计数明显增高并能反映内皮细胞损伤的程度,FAKps910、HSP70在病程中规律性变化,提示黏着斑(FAK)可能与汉坦病毒引起的整合素β3介导的血管内皮细胞损伤有关;而HFRS患者的CEC中HSP70表达增高,可能对CEC具有保护作用。CEC计数、FAKps910及HSP70还可作为早期病情的预测指标。Objective To investigate the clinical significance of circulating endothelial cells（CEC）and their expression of the phosphorylation state of serine 910 of focal adhesion kinase（FAKps910）and heat-shock protein 70（HSP70）in hemorrhagic fever of renal syndrome（HFRS） patients.Methods The study selected 20 healthy volunteers and 50 HFRS patients,the latter of which were with mild（17）,moderate（20） and severe（13） conditions,respectively.CEC count and the expression of FAKps910 and HSP70 were determined by Flow Cytometry.Results CEC count and the expression of HSP70 were all significantly increased during the first four stages of HFRS and returned to normal range in the recovery stage.The increases of CEC count and the expression of HSP70 were associated with the deterioration of disease conditions during the late fever or hypotension stage,and reached to peak in severe HFRS.The level of FAKps910 increased in the early febrile stage and decreased in the late febrile or hypotension stage.The decrease of FAKps910 was associated with aggravated condition in the late fever or hypotension stage of HFRS.Conclusions CEC count and the expression of FAKps910 and HSP70 have prognostic values for HFRS patients.The increases of CEC count and FAKps910 expression reflect the injuries of endothelial cells,which is similar to the mechanism of EC injuries mediated by hantavirus acting on β3 intergrin.The increase of HSP70 expression may play an important role in protecting EC among HFRS patients.

关 键 词：肾综合征出血热 循环内皮细胞 黏着斑激酶 热休克蛋白70 

分 类 号：R512.8[医药卫生—内科学]