中性粒细胞诱捕网在儿童分泌性中耳炎中的机制研究  

Research on the Mechanism of Neutrophil Extracellular Traps in Otitis Media with Effusion in Children

作　　者：沈世敏 杨志强[1,2] 徐雯 侯赟 王金鹏[3] 陈康兵 刘小涵[3] 和靖雅 陈小婉 SHEN Shimin;YANG Zhiqiang;XU Wen;HOU Yun;WANG Jinpeng;CHEN Kangbing;LIU Xiaohan;HE Jingya;CHEN Xiaowan(The First Clinical Medical College of Lanzhou University,Lanzhou 730030,China;不详)

机构地区：[1]兰州大学第一临床医学院,兰州730030 [2]成都市第三人民医院耳鼻咽喉-头颈外科 [3]兰州大学第一医院耳鼻咽喉-头颈外科

出　　处：《中华耳科学杂志》2024年第6期1011-1015,共5页Chinese Journal of Otology

基　　金：甘肃卫生行业计划(GSWSKY2020-14)。

摘　　要：目的通过研究中性粒细胞胞外诱捕网(neutrophil extracellular traps,NETs)及相关因子在分泌性中耳炎(otitis media with effusion,OME)患者中耳渗液中随病程的变化,探讨NETs在OME中的病理机制。方法纳入2021年1月至2021年12月兰州大学第一医院耳鼻咽喉头颈外科收治的行鼓膜穿刺或鼓室切开置管OME患者30例(40耳),伴腺样体肥大27例,伴鼻窦炎11例。根据病程分为短病程组(<3月)14耳、中病程组(3~6月)8耳,长病程组(>6月)18耳。通过免疫荧光、Pico Green DNA试剂盒测定DNA含量、Western Blot等方法对各组中耳积液中中性粒细胞弹性蛋白酶(neutrophil elastase,NE)、髓过氧化物酶(myeloperoxidase,MPO)、游离DNA、白细胞介素-8(interleukin-8,IL-8)及黏蛋白5B(mucin 5B,MUC5B)进行定性及定量分析。结果OME患者中耳积液中NE、MPO与游离DNA共定位,形成网状结构。中耳积液中游离DNA、NE、MPO、IL-8和MUC5B的含量随病程延长而增加,各组间差异均有统计学意义(P<0.05)。MPO与NE表达呈正相关,差异有统计学意义(P<0.05),MPO、NE与IL-8表达呈正相关,差异均有统计学意义(P<0.05)。结论NETs参与慢性OME的病理过程,含量水平受IL-8调控,其水平随病程延长而增加。OME患者中耳积液中MUC5B水平随病程延长而增多。Objective To investigate the role of neutrophil extracellular traps(NETs)in otitis media with effusion(OME)by studying their changes in middle ear effusion(MEE)and influencing factors.Methods Thirty-one patients with OME who underwent tympanotomy and/or tube placement at the Department of Otolaryngology Head and Neck Surgery,the First hospital of Lanzhou University,between 2021.01 to 2021.12,along with 27 cases of adenoid hypertrophy and 11 cases of sinusitis,were grouped based on disease duration,i.e.<3 months(14 cases),3-6 months(8 cases)and>6 months(18 cases).The levels of neutrophil elastate(NE),myeloperoxidase(MPO),cell-free DNA,interleukin-8(IL-8),and mucin 5B(MUC5B)in the MEE in each group were qualitatively and quantitatively analyzed by immunofluorescence,DNA content determination,and Western blot.Results NE and MPO were colocalized with cell-free DNA to form a network structure in all groups.Cell-free DNA,NE,MPO,IL-8 and MUC5B increased along with the duration of disease(P<0.05).Expression of MPO was positively correlated with NE(P<0.05),as well as for expression of MPO and NE and the expression of IL-8(P<0.05).Conclusion NETs are involved in the pathological process of OME and increase with the course of the disease,likely regulated by IL-8.The level of MUC5B in MEE in patients with OME shows an overall upward trend with the increase of the disease course.

关 键 词：分泌性中耳炎 中性粒细胞胞外诱捕网 白细胞介素-8 黏蛋白5B 

分 类 号：R764.21[医药卫生—耳鼻咽喉科]