突发性聋患者糖皮质激素治疗前后外周血单个核细胞Nrf2表达分析  

Study of the Expression of Nrf2 in Peripheral Blood Mononuclear Cells From Sudden Deafness Patients Treated with Methylprednisolone

作　　者：齐慧[1] 戴艳红[1] 后婕 周琼琼[1] 魏先梅[1] 杨烨[1] 佘万东[1] 

机构地区：[1]南京大学医学院附属鼓楼医院耳鼻咽喉科,南京210008

出　　处：《听力学及言语疾病杂志》2016年第1期1-4,共4页Journal of Audiology and Speech Pathology

基　　金：国家自然科学基金(81271074);江苏省临床医学科技专项(BL2014002);江苏省第十批"六大人才高峰项目"(WSN-009);南京市国际联合研究项目(2012sd311038)联合资助

摘　　要：目的探讨突发性聋（sudden sensorineural hearing loss,SSNHL）患者体内转录因子NF-E2相关因子2（nuclear factor erythroid2related factor,Nrf2）的变化及其与糖皮质激素（glucocorticoid,GC）抵抗的关系。方法分离30例SSNHL患者治疗前后外周血单个核细胞（peripheral blood mononuclear cells,PBMCs）,提取总RNA,采用实时荧光定量PCR（quantitative real time PCR,QRT-PCR）方法检测其PBMCs中Nrf2mRNA的表达量。根据就诊时间及用药情况将这30例SSNHL患者分为初发组（7例）和难治组（23例）;难治组又根据听力恢复是否≥15dB分为GC有效组（10例）及抵抗组（13例）;选择10例听力正常的志愿者为对照组;比较各组SSNHL患者治疗前后Nrf2mRNA表达量及与GC抵抗的关系。结果 130例患者中,治疗前难治组、初发组Nrf2mRNA表达量分别为0.520±0.049、0.514±0.052,两组间差异无统计学意义（F=0.052,P=0.911）,但均低于对照组（0.607±0.106）（F=6.483,P=0.004）;2治疗前难治组中GC有效组、抵抗组患耳0.25~8kHz平均听阈（pure tone average,PTA）分别为81.75±13.28和91.80±13.79dB HL,治疗后分别为54.67±15.65和89.87±13.98dB HL。治疗后GC有效组Nrf2 mRNA表达量（0.560±0.051）较治疗前（0.510±0.028）有所上调（t=3.007,P=0.015）,而GC抵抗组Nrf2mRNA表达量（0.519±0.054）较治疗前（0.526±0.060）无明显变化（t=0.485,P=0.636）。结论 Nrf2表达上调或下降可能参与SSNHL的发生发展;难治性SSNHL患者GC抵抗的机制可能与Nrf2低表达相关,上调Nrf2可能改善难治性SSNHL患者对GC的敏感性和预后。Objective To evaluate the expression of Nrf2 and the relationship in patients with sudden deafness.Methods PBMCs were collected from 10 hearing normal volunteers（control group）and 30 sudden sensorineural hearing loss patients before and after treatment with methylprednisolone for 10 days.We divided the SSNHL patients into 2groups（Initial treatment group and difficult-to-treat group）according to their visit time and treatment way.We also divided the difficult-to-treat SSNHL patients into 2groups（GC sensitive group and GC insensitive group）according to their hearing recovery.Quantitative Real Time PCR was used to detect the expression level of Nrf2 mRNA in PBMCs.The data were analyzed with SPSS 18.0software.Results Before accept treatment,the expression level of Nrf2 mRNA in PBMCs from Initial treatment group and difficult-to-treat group were below control group whereas there was no obvious difference between the two groups.The Nrf2 mRNA expression in GC sensitive group increased whereas The Nrf2 mRNA expression in GC insensitive group had no obvious change after10 days treatment with methylprednisolone.Conclusion Nrf2 may take part in the generation and development in SSNHL.Difficult-to-treat SSNHL with corticosteroid in-sensitivity may have relationship with the lower Nrf2 expression.We speculate that increasing the expression of Nrf2 may improve the effect of glucocorticoids and has a positive effect for hearing improvement.

关 键 词：突发性聋 糖皮质激素 NF-E2相关因子2 外周血单个核细胞 

分 类 号：R764.433[医药卫生—耳鼻咽喉科]