重症流行性出血热患者PBMC中Fas/FasL表达及免疫机制研究  

Study on Expression of Fas/FasL in PBMC of Patients with Severe Epidemic Hemorrhagic Fever and Its Immune Mechanism

作　　者：李珊 LI Shan(Department of Critical Medicine,Nanping First Hospital,Fujian,Nanping353000)

机构地区：[1]福建省南平市第一医院重症医学科,南平353000

出　　处：《实用中西医结合临床》2022年第5期12-15,共4页Practical Clinical Journal of Integrated Traditional Chinese and Western Medicine

基　　金：福建省卫生健康委青年课题项目(编号:2017-1-94)。

摘　　要：目的:探讨重症流行性出血热5期中各阶段外周血单个核细胞(PBMC)中Fas/FasL表达情况及相关免疫机制。方法:选取经典5期经过的重症流行性出血热患者50例,分为发热期组(Ⅰ期组)、低血压休克期组(Ⅱ期组)、少尿期组(Ⅲ期组)、多尿期组(Ⅳ期组)和恢复期组(Ⅴ期组)。AO/EB双染色观察各组PBMC细胞的凋亡率;ELISA法检测外周血中TNF-α、IL-6水平;RT-PCR和Western Blot法分别检测Fas、FasL基因和蛋白的表达。结果:Ⅰ期组、Ⅱ期组、Ⅲ期组PBMC细胞凋亡率明显高于Ⅳ期组和Ⅴ期组,差异均有统计学意义(1 h:F=29.12,P<0.001;6 h:F=27.54,P<0.001;12 h:F=25.23,P=0.003;24 h:F=18.17,P=0.005)。Ⅰ期组、Ⅱ期组、Ⅲ期组外周血PBMC中的Fas和FasL蛋白表达较Ⅴ期组明显升高,差异均有统计学意义(P<0.05);Ⅰ期组、Ⅱ期组及Ⅲ期组PBMC中的Fas和FasL mRNA表达亦较Ⅴ期组明显升高,差异均有统计学意义(P<0.05)。前3期组的TNF-α、IL-6水平较Ⅴ期组明显升高,尤其是Ⅰ期组致炎因子最高,Ⅳ期组表达量水平相对较低,差异均有统计学意义(TNF-α:F=42.35,P<0.001;IL-6:F=31.27,P<0.001)。结论:重症流行性出血热的病理机制存在Fas/FasL介导的细胞凋亡,其浓度高低与机体损害的程度有关。Objective:To investigate the expression of Fas/FasL in peripheral blood mononuclear cells(PBMC)and its related immune mechanism in phase 5 of severe epidemic hemorrhagic fever.Methods:Fifty patients with severe epidemic hemorrhagic fever who passed through the classic phase 5 were divided into fever phase group(phaseⅠgroup),hypotension shock phase group(phaseⅡgroup),oliguria phase group(phaseⅢgroup),polyuria phase group(phaseⅣgroup)and recovery phase group(phaseⅤgroup).The apoptosis rate of PBMC cells in each group were observed by AO/EB double staining;detection of TNF-α,IL-6 level in peripheral blood by ELISA;RT-PCR and Western Blot were used respectively to detect the expression of Fas and FasL genes and proteins.Results:The apoptosis rate of PBMC in phaseⅠgroup,phaseⅡgroup and phaseⅢgroup were significantly higher than those in phaseⅣgroup and phaseⅤgroup,the differences were statistically significant(1 h:F=29.12,P<0.001;6 h:F=27.54,P<0.001;12 h:F=25.23,P=0.003;24 h:F=18.17,P=0.005).The expression of Fas and FasL protein in PBMC in phaseⅠgroup,phaseⅡgroup and phaseⅢgroup were significantly higher than those in phaseⅤgroup,there were significant differences(P<0.05).The expression of Fas and FasL mRNA in PBMC in phaseⅠgroup,phaseⅡgroup and phaseⅢgroup were also significantly higher than those in phaseⅤgroup,there were significant differences(P<0.05).The levels of TNF-αand IL-6 in the phaseⅠgroup,phaseⅡgroup and phaseⅢgroup were significantly higher than those in the phaseⅤgroup,especially the inflammatory factors in the and phaseⅢgroup phaseⅠgroup was the highest,and the expression level in the phaseⅣgroup was relatively low,the differences were statistically significant(TNF-α:F=42.35,P<0.001;IL-6:F=31.27,P<0.001).Conclusion:The pathological mechanism of severe epidemic hemorrhagic fever is Fas/FasL mediated apoptosis,and its concentration is related to the degree of body damage.

关 键 词：重症流行性出血热 细胞凋亡 外周血单个核细胞 

分 类 号：R512.8[医药卫生—内科学]