转化生长因子-β_1/Smad信号转导在强直性脊柱炎骶髂关节中表达的研究

目的 了解强直性脊柱炎(AS)骶髂关节中转化生长因子(TGF)-β_1/Smad信号转导通路中主要分子的表达情况,探讨TGF-β_1/Smad信号转导在AS发病机制中的作用.方法 53例AS患者均检测血清TGF-β_1.及红细胞沉降率(ESR)、C反应蛋白(CRP)水平.其中30例行CT导引下穿刺活检取得骶髂关节组织,通过免疫组织化学方法,检测TGF-β_1、p-Smad3、Smad7的表达.采用多个样本均数的单因素方差分析、两样本均数的t检验以及Kolmogorov-Smimov检验进行统计学处理.结果 AS患者中ESR/CRP升高组血清TGF-β_1(15.9±5.6)ng/ml,较健康对照组、ESR/CRP健康组[(5.4±5.8)ng/ml和(4.1±3.6)ng/ml]均明显升高.与健康对照组相比,AS骶髂关节组织可见TGF-β_1高表达,主要在血管翳中炎症细胞的胞质中表达;Smad7明显低表达;p-smad3则主要表达于骨髓及血管翳中炎症细胞的细胞核中,提示smad3已被激活.结论 AS中存在TGF-β_1的过高表达,Smad信号通路的激活,Samd7的低表达,可能与AS骶髂关节炎症活动、软骨的纤维化变性有关.

Expression of transforming growth factor beta and Smad signalling in ankylosing spondylitis

Objective To investigate the expression of transforming growth factor beta (TGF-β) and Smad signaling in ankylosing spondylitis (AS) and to explore their roles in the pathogenesis. Methods Fiftythree patients with AS were included in the study. In these 53 cases, 30 patients were performed computed tomography-guided needle biopsy in sacroiliac joint. Serum TGF-β_1 was determined by enzyme-linked immunosorbent assay (ELISA). Immunohistological studies were performed with the streptavidin-peroxidase conjugated methods to assess the expression of TGF-β_1, p-smad3 and Smad7 in sacroiliac joint tissue sample.One-way ANOVA, two independent samples t test and kolmogoorov-Simimov test were used to do statistical analysis. Results In 53 cases patients with AS, 20 cases were with high level Erythro-cyte sedimentation rate(ESR) and C-reactive protein (CRP), while those of the other 33 cases were normal. Serum average TGF-β_1level [ (15.9±5.6) ng/ml ], in patients with high level ESR/CRP [(5.4±5.8) ng/ml ] was significantly increased as compared to the controls and patients with normal ESR/CRP [(4.1±3.6) ng/ml] (P<0.05). There was no expression of TGF-β_1 could be detected in the pannus and bone marrow in SI joints tissue of 30 cases with AS, while decreased level of smad7 expression was detected. In addition, p-smad3 expression was found in the nuclear. Conclusion TGF-β_1 signaling may play an important role in the inflammatory erosion and cartilage fibrosis of sacrojlitis in AS.