神经生长相关蛋白-43基因及其蛋白在先天性巨结肠肠组织中的表达  

Expression of Growth Associated Protein-43 in Intestinal Tissues of Patients with Hirschsprung Disease

作　　者：黄发新[1,2] 刘磊[1] 王建尧[1] 徐金永[1] 

机构地区：[1]深圳市儿童医院普外科,广东深圳518038 [2]遵义医学院临床学院,广东珠海519090

出　　处：《中国普外基础与临床杂志》2015年第3期339-342,共4页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的探索神经生长相关蛋白-43(GAP-43)在先天性巨结肠痉挛段和扩张段肠组织中的表达情况,进一步探索先天性巨结肠的发病机理。方法收集2012年1月至2013年6月期间因先天性巨结肠于深圳市儿童医院行巨结肠根治术的30例患儿的活体肠组织标本,行免疫组化染色及荧光定量聚合酶链反应(RT-PCR)以检测扩张段和狭窄段肠组织中GAP-43 m RNA及其蛋白的表达,并比较扩张段和狭窄段肠组织中两者表达的差异。结果RT-PCR结果显示,痉挛组肠组织中GAP-43 m RNA的表达水平的中位数为0.052 8,低于扩张组的0.119 0(P<0.05)。免疫组化染色结果显示:30例患儿的狭窄段肠组织和扩张段肠组织的肌间神经丛及黏膜下神经丛中GAP-43蛋白均呈阳性表达,但痉挛段黏膜下神经丛和肌间神经丛的染色均较扩张段相应部位浅;与扩张组的黏膜下神经丛和肌间神经丛比较,痉挛组相应部位的GAP-43蛋白的平均光密度值均较低(P<0.05)。结论先天性巨结肠狭窄段肠组织中GAP-43蛋白的表达较扩张段肠组织下调,提示GAP-43蛋白可能是先天性巨结肠发病的危险因素之一。Objective To explore the expression of growth associated protein-43（GAP-43） in spasm segment and expansion segment of hirschsprung disease（HD）, and to explore the pathogenesis of HD. Methods The expression of GAP-43 in 30 patients with HD who underwent surgical resection for absence of enteric plexuses from Jan. 2012 to Jun. 2013 in Shen Zhen Children’s Hospital were analyzed by using immunohistochemistry method and real-time PCR method. Aganglionic tissues of all patients were included as spasm group, and ganglionic tissues of the same patients were served as expansion group. Then comparison of the expression levels of GAP-43 m RNA and its protein between 2 groups was performed. Results Results of real-time RCR showed that the expression level of GAP-43 m RNA in expansion group was higher than that of spasm group（0.119 0 vs. 0.052 8, P〈0.05）. Immunohistochemistry results showed that GAP-43 protein expressed both in the myenteric plexus and ganglionic plexus of submucos in all patients, but lighter in spasm group. Compared with ganglionic plexus of circular muscle layer and longitudinal muscle layer/ganglionic plexus of submucosa in expansion group, the average optical density values at corresponding sites of intestinal tissues in spasm group were both lower（P〈0.05）. Conclusion Expression of GAP-43 protein is lower in spastic intestinal tissue of patients with HD, which suggests that down-regulation of GAP-43 protein may be a risk factor for HD.

关 键 词：神经生长相关蛋白-43 先天性巨结肠 肠神经系统 免疫组化染色 荧光定量聚合酶链反应 

分 类 号：R726.5[医药卫生—儿科]