酒精性肝硬化患者体外单核细胞肿瘤坏死因子及其受体的表达

为调查酒精性肝硬化（ＡＣ）患者周围血单核细胞肿瘤坏死因子（ＴＮＦα）和可溶性肿瘤坏死因子受体（ｓＴＮＦＲ）自然表达和是否通过内毒素脂多糖（ＬＰＳ）或酒精刺激后表达增强，用酶联免疫吸附试验（ＥＬＩＳＡ）对其进行了定量测定。结果示ＡＣ组ＴＮＦα和ｓＴＮＦＲｐ５５、ｐ７５自然表达较正常组增强。经ＬＰＳ刺激后ＴＮＦα、ｓＴＮＦＲｐ５５、ｐ７５的表达不论在ＡＣ组还是健康组均较自发性表达增加，但ＡＣ组较正常组明显增高，Ｐ值分别＜０．０５，＜０．０１，＜０．０５。经酒精刺激后不论ＡＣ组还是正常组ＴＮＦα、ｓＴＮＦＲｐ５５的表达与自发性表达无差异，虽然ｓＴＮＦＲｐ７５的表达较正常组增高，但这种差异在自发性表达中已显示出来。这些结果提示ＡＣ组血清中ＴＮＦα和ｓＴＮＦＲ水平升高与体内单核细胞活化有关，它的活化受其内毒素影响，酒精对其活化未显示直接作用。持续性ＴＮＦα和ｓＴＮＦＲ水平增高是促进ＡＣ发生和发展的重要因素。

MONOCYTE TUMOR NECROSIS FACTOF AND TUMOR NECROSIS FACTOR RECEPTOR EXPRESSION IN PATIENTS WITH ALCOHOLIC LIVER CIRRHOSIS

We evaluated the spontaneous production of tumor necrosis factor alpha(TNF alpha) and soluble tumor necrosis factor receptor (sTNFR) and determined whether TNF alpha and sTNFR expression on mononuclear cells in vitro in patients with alcoholic liver cirrhosis (AC) was induced by lipopolysaccharide (LPS) or ethanol stimulation. Their levels were examined by an enzyme-linked immunosorbent assay (ELISA). Patients with alcoholic cirrhosis showed higher spontaneous expression in TNF alpha and sTNFRp55, p75 on monocyte than controls. The concentration of TNF alpha and both sTNFR from LPS-stimulated peripheral blood monocyte either in patients or in healthy controls was markedly increased as compared with spontaneous production. The patients showed significantly higher level of TNF alpha and both sTNFRp55, p75 than controls (P < 0.05, P < 0.01, P < 0.005 respectively). Increased TNF alpha and both sTNFR expressions following ethanol stimulation were not found neither in patients nor in controls. These data suggest that elevated TNF alpha and sTNFR levels in serum are correlated with activation of mononuclear cells in vivo, which is closely correlated with endotoxin, but no direct correlation with ethanol is found.