感染对IBS患者肠黏膜细胞因子表达的影响

目的:探讨感染对肠易激综合征(irritable bowel syndrome,IBS)患者神经-免疫-内分泌网络的影响.方法:感染后肠易激综合征(postinfectious irritable bowel syndrome,PI-IBS)患者45例,non-PI-IBS患者60例及30例对照者,结肠镜下活检回盲部黏膜标本,采用免疫组织化学法检测其肠黏膜SP、IL-2、IFN-γ、SPR与5-HT的表达,肥大细胞(mast cells,MC)采用甲苯胺蓝染色.结果:PI-IBS患者的SP表达分别高于non-PI-IBS与对照组(t=2.5,2.8,P<0.01);PI-IBS患者的MC表达分别高于non-PI-IBS与对照组(t=11.5,12.1,P<0.01).PI-IBS患者的5-HT表达分别高于non-PI-IBS与对照组(t=13.6,14.1,P<0.01);PI-IBS患者的SPR表达分别高于non-PI-IBS与对照组(t=3.8,6.1,P<0.05);PI-IBS患者的IFN-γ表达分别高于non-PI-IBS与对照组(t=13.8,15.2,P<0.05);PI-IBS患者的IL-2表达分别高于non-PI-IBS与对照组(t=12.6,14.7,P<0.05).PI-IBS患者回盲部黏膜MC和SP的表达呈高度正相关(r=0.71,P<0.01).PI-IBS患者回盲部黏膜5-HT和SPR的表达呈密切相关(r=0.18,P<0.05).IFN-γIL-2阳性表达的PI-IBS患者,SP表达高于非PI-IBS组(r=2.2,2.3,P<0.05)和对照组(t=2.3,2.4,P<0.05).结论:肠道感染后,神经纤维在IBS的免疫-神经-内分泌发生机制中的作用至关重要.

Effect of infection on cytokine expression in the colon mucosa of patients with irritable bowel syndrome

AIM:To explore the impact of infection on the immune-nervous-endocrine network in patients with irritable bowel syndrome(IBS).METHODS:Forty-five patients with postinfectious IBS(PI-IBS),60 patients with nonpostinfectious IBS(non-PI-PBS),and 30 healthy controls were included.Immunohistochemical staining was performed to analyze the expression of substance P(SP),interleukin(IL)-2,5-hydroxytryptamine(5-HT),interferon(IFN)-γ,substance P receptor(SPR) in the colon mucosa of these subjects.Mast cells(MCs) were stained with toluidine blue.RESULTS:The expression of SP,MCs,5-HT,SP-R,IFN-γ,and IL-2 in PI-IBS patients was higher than that in non-PI-IBS patients and controls(t = 2.5,2.8,both P < 0.01;t = 11.5,12.1,both P < 0.01;t = 13.6,14.1,both P < 0.01;t = 3.8,6.1,both P < 0.05;t = 13.8,15.2,both P < 0.05;t = 12.6,14.7,both P < 0.05).The expression of ileocecal mucosal MCs was positively correlated with that of SP in PI-IBS patients(r = 0.71,P < 0.01).The expression of ileocecal mucosal 5-HT was closely associated with that of SPR in PI-IBS patients(r = 0.18,P < 0.05).SP expression in PIIBS patients who were positive for IFN-γ or IL-2 was higher than that in non-PI-IBS patients(t = 2.22,2.3,P < 0.05) and controls(t = 2.3,2.4,P < 0.05).CONCLUSION:Nerve fibers are critical for the immune-nervous-endocrine network in IBS patients after intestinal infection.