凋亡相关蛋白Bcl-2和Bax在慢性鼻及鼻窦炎伴嗅觉障碍患者嗅黏膜中的表达  

Expression of the apoptosis associated protein Bcl-2 and Bax in olfactory epithelium of patients suffering from dysosmia caused by chronic rhinosinusitis

作　　者：李力[1] 张燕[2] 蒲建章[3] 李桂芳[4] 叶鸣[1] 

机构地区：[1]北京市顺义区医院耳鼻咽喉科,北京101300 [2]河北医科大学第二医院耳鼻咽喉科,河北石家庄050000 [3]北京市顺义区医院神经外科,北京顺义101300 [4]河北省邢台市眼科医院耳鼻咽喉科,河北邢台054001

出　　处：《中国耳鼻咽喉头颈外科》2012年第1期29-32,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的研究Bcl-2和Bax在慢性鼻及鼻窦炎(CRS)伴嗅觉障碍患者嗅黏膜中的表达,探讨其对嗅觉神经元(olfactory receptor neurons,ORNs)凋亡的调节作用。方法采用康涅狄格化学感受临床研究中心所采用的嗅觉检查法——CCCRC(Connecticut ChemosensoryClinical Research Center)对46例行功能性鼻内镜手术的患者进行嗅觉评分并分组:A组,CRS伴嗅觉障碍25例;B组,CRS不伴嗅觉障碍10例;C组,单纯鼻中隔偏曲行鼻中隔矫正术11例。免疫组织化学方法检测Bcl-2、Bax在3组患者嗅黏膜中的表达。结果在ORNs中,A组Bcl-2和Bax表达显著高于B组(q=3.24、4.29,P均<0.05)和C组(q=8.56、12.99,P均<0.01),A组Bcl-2/Bax比值显著低于B组(q=3.76,P<0.05)和C组(q=6.67,P<0.01);在基底细胞中,Bcl-2在3组表达无显著差异(q=0.68、0.69、1.06,P均>0.05),Bax在A组的表达显著高于B组和C组(q=9.54、11.98,P均<0.01),A组Bcl-2/Bax比值显著低于B组和C组(q=5.48、9.14,P均<0.01);在A、B、C 3组ORNs和基底细胞中,Bcl-2/Bax比值与嗅觉评分均呈正相关(rA分别为0.5631、0.8926,rB分别为0.5700、0.7991、rC分别为0.5694、0.8121,P均<0.01)。结论细胞凋亡参与了CRS伴嗅觉障碍患者ORNs的减少,Bcl-2和Bax在此过程中起了重要的调控作用,Bcl-2/Bax比值决定细胞是否凋亡。OBJECTIVE To study the expression of the apoptosis associated protein Bcl-2 and Bax in olfactory epithelium of patients suffering from dysosmia caused by chronic rhinosinusitis,to investigate the accomodation of Bcl-2 and Bax on the apoptosis of olfactory receptor neurons（ORNs）.METHODS Forty six patients undergoing FESS were chosen.Before operation,their olfactory functions were examined with CCCRC.According to their CCCRC scores,they were distributed into three groups.Group A： twenty-five patients with chronic rhinosinusitis and dysosmia;Group B： ten patients with chronic rhinosinusitis and normal olfactory function;Group C： eleven patients with deviation of nasal septum and normal olfactory function.The expressions of Bcl-2,and Bax in olfactory mucosas of three groups were measured by immuno-histochemistry.RESULTS In ORNs,the expression of Bcl-2 and Bax in group A was higher than that in group B and in group C（q=3.24,4.29,P0.05;q=8.56,12.99,P0.01）,the ratio of Bcl-2/ Bax in group A was lower than that in group B（q=3.76,P0.05）and group C（q=6.67,P0.01）;In basal cells,the expression of Bcl-2 showed no significant difference between group A、group B and group C（q=0.68,0.69,1.06,P0.05）,the expression of Bax showed a higher level in group A than that in group B and group C（q=9.54,11.98,P 0.01）,the ratio of Bcl-2/Bax in group A was lower than that in group B and group C（q =5.48,9.14,P0.01）.There was a positive correlation between the Bcl-2/Bax ratio and CCCRC score both in ORNs and in basal cells of all the 3 groups（ORNs： rA=0.5631,0.5700,0.5694,P0.01;basal cells： rA=0.8926,0.7991,0.8121,P 0.01）.CONCLUSION The mechanism of the loss of ORNs in patients suffering from dysosmia caused by chronic sinusitis mostly resulted from cell apoptosis.Bcl-2 and Bax may play an important regulate effect on the apoptosis of olfactory receptor neurons.Cell apoptosis may be determined by the ratio of Bcl-2/Bax.

关 键 词：鼻窦炎 嗅觉障碍 嗅觉受体神经元 细胞凋亡 

分 类 号：R765[医药卫生—耳鼻咽喉科]