糖皮质激素受体和热休克蛋白90与原发免疫性血小板减少症患者糖皮质激素抵抗关系的研究  

Relationship between the expressions of glucocorticoid receptors α、β、τ、ρ and heat shock protein 90 mRNA in patients with primary immune thrombocytopenia resistant to the glucocorticoid

作　　者：马亮亮[1] 梁燕[1] 方美云[1] 

机构地区：[1]大连医科大学附属第一医院血液科,116011

出　　处：《中华血液学杂志》2012年第9期733-737,共5页Chinese Journal of Hematology

基　　金：卫生行业科研专项（200802031）;中国医师协会血液分会课题（20100136）;大连市科委科技计划（2009E12SF166）

摘　　要：目的探讨初诊原发免疫性血小板减少症（ITP）患者外周血单个核细胞（PBMC）糖皮质激素（GC）受体（GR）亚型α、β、τ、ρ及热休克蛋白90（HSP90）与糖皮质激素抵抗（GCR）的关系。方法初诊ITP患者40例。28例患者接受泼尼松治疗，根据疗效分为糖皮质激素敏感（GCS）组（22例）和GCR组（6例）。以29名健康志愿者为正常对照组。采用实时荧光定量PCR方法检测GRα、GRβ、GRγ、GRp和HSP90mRNA表达。分析患者组与正常组、GCS组和GCR组GRα、GRβ、GRγ、GRp、HSP90mRNA和HSP90／GRa的组间表达差异。结果ITP患者组HSP90mRNA的表达[0．91（0．48—2．21）]低于正常对照组[1．41（0．83—2．61）]（P〈0．05）。GRdmRNA在GCS组明显高于GCR组（P〈0．05），GRβ、GRγ、GRp、HSP90mRNA的表达和HSP90／GRα在GCS组和GCR组间差异均无统计学意义（P〉0．05）。结论初诊ITP患者存在HSP90mRNA表达的减少。ITP患者的GC抵抗与GRd表达减少有关；GRβ含量极低，可能不介导GC效应。Objective To investigate the expressions of GRα, GRβ, GRγ, GRp and heat shock protein 90 （HSP90） in primary immune thrombocytopenia （ITP） patients and their correlations with glucocorticoid resistance. Methods The expressions of glucoeorticoid receptors （ GRα, GRβ, GRγ, GRp） mRNA and HSP90 in peripheral blood mononuclear cells of 40 newly diagnosed ITP patients and 29 healthy volun- teers were examined by real time PCR. Of them, 28 patients received glucocorticoid （GC）therapy divided into GC sensitive group （GCS） and GC resistant group （GCR） according to GC response. GRα, GRβ, GRγ, GRp, HSP90 mRNA and HSP90/GRα were analyzed in paired groups. Results The expression of HSP90 mRNA was significantly decreased in ITP patients [0.91 （0.48 - 2.21 ） ] than in normal subjects [ 1.41 （0.83 -2.61 ）] （P 〈0.05）. There were no significant differences in mRNA expressions of GRα, GRβ, GRγ, GRp and HSP90/GRα between ITP patients and normal controls. The expression of GRcL mRNA in GCS patients was significant higher than in GCR patients（ P 〈 0.05 ）. Moreover, no significant differences in mRNA expressions of GRβ, GRγ, GRp and HSP90 and the ratio of HSP90 to GRα were observed between GCS and GCR patients. Conclusion The expression of HSP90 mRNA decreased in adult ITP patients. GC resistance in adult ITP patients was associated with reduced expression of GRα. The very low expression of GRβ mRNA may be not involved in GC resistance in adult ITP.

关 键 词：受体 糖皮质激素 HSP90热休克蛋白质类 免疫性血小板减少症 糖皮质激素 抵抗 

分 类 号：R558[医药卫生—血液循环系统疾病]