获得性囊性纤维化跨膜传导调节因子功能障碍及炎性因子在儿童鼻-鼻窦炎中的表达特征分析  

Expression of inflammatory cytokines and acquired CFTR dysfunction in children with rhinosinusitis

作　　者：韩阳[1] 刘雯菁 王蓬鹏[1] 唐力行[1] 贾超 王铁山 秦瑜 葛文彤[1,4] Han Yang;Liu Wenjing;Wang Pengpeng;Tang Lixing;Jia Chao;Wang Tieshan;Qin Yu;Ge Wentong(Department of Otolaryngology,Head and Neck Surgery,Beijing Children’s Hospital,Capital Medical University,National Center for Children’s Health,Beijing 100045,China;Department of Pathology,Beijing Children’s Hospital,Capital Medical University,National Center for Children’s Health,Beijing 100045,China;Beijing University of Chinese Medicine,Beijing 102488,China;Beijing Key Laboratory of Otolaryngology,Head and Neck Surgery,Beijing 100045,China)

机构地区：[1]国家儿童医学中心首都医科大学附属北京儿童医院耳鼻咽喉头颈外科,北京100045 [2]国家儿童医学中心首都医科大学附属北京儿童医院病理科,北京100045 [3]北京中医药大学,北京102488 [4]北京市耳鼻咽喉科疾病重点实验室,北京100045

出　　处：《中国医刊》2023年第8期856-861,共6页Chinese Journal of Medicine

基　　金：国家呼吸系统疾病临床医学研究中心呼吸专项(HXZX-20210501)。

摘　　要：目的探讨获得性囊性纤维化跨膜传导调节因子(cystic fibrosis transmembrane conductance regulator,CFTR)功能障碍及炎性细胞因子在儿童鼻-鼻窦炎发展中的作用。方法纳入2021年1—12月在首都医科大学附属北京儿童医院耳鼻咽喉头颈外科因急慢性鼻-鼻窦炎行鼻内镜手术治疗31例患儿,其中慢性鼻窦炎(chronic rhinosinusitis,CRS)患儿17例(CRS组),急性细菌性鼻窦炎(acute bacterial rhinosinusitis,ABRS)患儿14例(ABRS组)。收集所有患儿的全血、鼻黏膜及鼻息肉样本,应用全外显子二代测序技术检测全血样本中CFTR基因的表达情况,q RT-PCR检测息肉和黏膜组织中CFTR mRNA的表达水平,微量样本多重蛋白定量技术(cytometric bead array,CBA)检测息肉和黏膜组织中炎性细胞因子的表达水平。结果根据CFTR基因检测结果,所有入组患儿均排除囊性纤维化。ABRS组鼻黏膜组织CFTR mRNA的表达水平明显低于CRS组,而CRS组鼻息肉组织CFTR mRNA的表达水平明显低于鼻黏膜组织。ABRS组鼻黏膜组织γ干扰素(interferon-γ,IFN-γ)、白细胞介素-4(interleukin-4,IL-4)、IL-13、IL-6、IL-8的表达水平明显高于CRS组(P<0.05),而CRS组鼻息肉组织IL-6、IL-8、单核细胞趋化因子-1(monocyte chemoattractant protein-1,MCP-1)的表达水平明显高于鼻黏膜组织(P<0.01)。结论获得性CFTR功能障碍及与中性粒细胞趋化相关的炎性因子在ABRS中的作用更为明显,在CRS息肉的发生发展中也可能起到一定作用。Objective To explore the role of acquired cystic fibrosis transmembrane conductance regulator(CFTR)dysfunction and inflammatory chemokines in the development of rhinosinusitis in children.Method Thirty-one children who underwent endoscopic sinus surgery for acute and chronic rhinosinusitis in the Department of Otolaryngology Head and Neck Surgery at Beijing Children’s Hospital from January 2021 to December 2021 were included.There were 17 cases in the chronic rhinosinusitis(CRS)group and 14 cases in the acute bacterial rhinosinusitis(ABRS)group.Whole blood,mucosa and polyp tissues of all children were collected for study.The CFTR gene was detected by using Full-length second-generation sequencing.The expression of CFTR mRNA was measured by qRT-PCR,and the expression of inflammatory chemokines was measured by CBA.Result All enrolled children were excluded from the diagnosis of cystic fibrosis based on the results of CFTR gene testing.The expression of CFTR mRNA in nasal mucosa of ABRS group was significantly lower than that of CRS group.The expression of CFTR mRNA in nasal polyps of CRS group was significantly lower than that of nasal mucosa.The levels of IFN-γ,IL-4,IL-13,IL-6 and IL-8 in nasal mucosa of ABRS group were significantly higher than those of CRS group(P<0.05).The expression levels of IL-6,IL-8,MCP-1 in polyps were significantly higher than those in mucosa(P<0.01).Conclusion The dysfunction of acquired CFTR and the role of neutrophil chemotactic factor are more obvious in ABRS,and may play a role in the occurrence and development of CRS polyps.

关 键 词：囊性纤维化跨膜传导调节因子 鼻-鼻窦炎 炎性细胞因子 儿童 

分 类 号：R765.41[医药卫生—耳鼻咽喉科]