检测DM2患者血浆tPA、PAI-1、uPA及uPAR水平的价值

目的:检测2型糖尿病(DM2)血浆tPA、PAI-1、uPA及uPAR水平,探讨其临床价值.方法:分别以ELISA检测尿蛋白正常组、尿蛋白阳性组、严重尿蛋白组和对照组的tPA、PAI-1、uPA及uPAR水平.结果:与对照组相比,尿蛋白正常组的tPA和PAI-1变化不明显(P＞0.05);尿蛋白阳性组tPA活性明显下降...     

uPA/uPAR/PAI与消化系统肿瘤

消化系统肿瘤在我国的肿瘤发病率中占第1位.从尿激酶型纤溶酶原激活物受体(urokinase plasminogen activator receptor, uPAR)首次被描述为尿激酶型纤溶酶原激活物(urokinase plasminogen activator, uPA)链的细胞表面高亲和性激活剂以来,越来越受到研究者的关注.研究表明:uPA,uPAR及尿激酶型纤溶酶原激活物抑制剂(urokinase plasminogen activator inhibitor, PAI)与消化系统肿瘤侵袭和转移密切相关.本文对uPA,uPAR及PAI与胃癌、食管癌、结肠癌、肝癌、胰腺癌等侵袭与转移的关系进行综述.     

uPA／uPAR研究进展

纤溶酶原激活剂 /纤溶酶原激活剂抑制剂 (PA/PAI)系统是一个蛋白水解酶激活剂 /激活剂抑制剂系统 ,包括 6种成员 ,即尿激酶型PA(uPA)、组织型PA(tPA)、1型PA抑制剂 (PAI 1)、2型PA抑制剂 (PAI 2 )、3型抑制剂 (PAI 3)及uPA受体 (uPAR) ,其中uPA/uPAR系统是其中较为重要的成分。uPA/uPAR参与细胞因子和其他因子的激活、黏着键的裂解、细胞外基质的破坏、生物活性介质的失活、细胞内蛋白的水解以及信号的转换等重要活动。它与体内纤溶、生殖、皮肤上皮分化生长和再生过程及肿瘤细胞的转移浸润密切相关。     

CNSI患者血浆中uPA及其受体（uPAR）的变化和临床意义

目的：研究中枢神经系统感染（CNSI）患者血浆中尿激酶型纤溶酶原激活物（uPA）及其受体（uPAR）的变化及意义。方法：收集我院2006年10月～2008年7月CNSI住院患者69例,将CNSI病例分为病毒性脑炎组、结核性脑膜炎组、化脓性脑膜炎组,并设立对照组。用双抗体夹心酶联免疫法检测所有CNSI病例血浆中uPA及其受体（uPAR）水平。结果：化脓性脑膜炎组、结核性脑膜炎组uPA及其受体（uPAR）水平明显高于病毒组及对照组（P〈0.01）,血浆uPAR浓度改变与uPA同步,但uPAR升高水平高于uPA。结论：血浆中uPA及其受体（uPAR）水平在化脓性脑膜炎、结核性脑膜炎中升高,可为化脓性脑膜炎、结核性脑膜炎、病毒性脑炎的鉴别诊断提供更多的实验室依据。     

肝癌细胞株雌二醇与uPAR表达的关系

目的 观察人肝癌BEL-7402细胞株中雌二醇与uPAR表达的关系。方法 将肝癌BEL-7402细胞株培养于不同浓度雌二醇的培养液中，培养24h、48h及72h后收集各组细胞。通过免疫组化实验，检测各组细胞uPAR的表达。结果 雌二醇作用后的BEL-7402细胞uPAR表达的阳性率明显高于对照组（P〈0．05）。结论 雌二醇可促进肝癌BEL-7402细胞株uPAR的表达。     

uPA系统与神经胶质瘤局部侵袭

uPA系统包括尿激酶型纤溶酶原激活物（urokinase plasminogen activator, uPA）、 尿激酶型纤溶酶原激活物受体（urokinase plasminogen activation receptor, uPAR）和纤溶酶原激活物抑制剂(plasminogen activator inhibitor, PAI),它们参与了多种人类恶性肿瘤的局部侵袭和转移,是目前肿瘤治疗重要的分子靶点。uPA能激活纤溶酶原降解细胞外基质与基底膜,uPAR则能显著提升uPA的激活纤溶酶原的功能,两者结合能够增强肿瘤的侵袭性与转移能力。PAI主要通过促进血管内皮生长因子（vascular endothelial growth factor,VEGF）的表达,促进新生血管的形成,从而促进肿瘤的局部侵袭,但PAI又可通过抑制uPA-uPAR复合体的生物学活性来抑制肿瘤的局部侵袭。神经胶质瘤是最常见的颅内肿瘤,很少转移到颅外,局部侵袭是其预后不良的主要原因。近年来发现uPA系统的表达水平与神经胶质瘤的恶性程度呈正相关。本文综述了uPA系统对神经胶质瘤局部侵袭的影响及其在治疗中的意义。     

uPA和PAI-1在肺纤维化中的作用

慢性炎症和纤维化疾病都以炎性细胞和介质的聚集为特征 ,并且细胞外基质及纤溶酶系统均有明显的改变。目前发现 ,纤溶酶原激活系统的改变是肺纤维化发展中一个非常关键的环节。研究表明各种肺纤维化患者的支气管灌洗液 (BAL)中纤溶酶原活性受到的损害往往是由于尿激酶型纤溶酶原激活物 (uPA)缺失 ,以及纤溶酶原激活因子抑制物 1(PAI 1)表达增加所致。     

uPA/uPAR/PAI系统与炎性关节疾病

近年来研究表明,尿激酶型纤溶酶原激活剂(urokinase-type plasminogen activator,uPA)/尿激酶型纤溶酶原激活剂受体(uPA receptor,uPAR)/纤溶酶原激活剂抑制剂(plasminogen activator inhibitor,PM)系统与炎性关节疾病中滑膜增生以及关节软骨和骨的破坏密切相关,本文就近年来的研究进展作一综述,旨在为炎性关节疾病的防治寻找新的靶点和途径.     

多囊卵巢综合征患者血PAI-1和uPA含量的变化

目的观察多囊卵巢综合征(PCOS)患者外周血纤溶酶原激活抑制物1(PAI-1)和尿激酶型纤溶酶原激活物(uPA)的水平。方法实验分PCOS组和对照组,PCOS组又分为肥胖组和正常体重组,用酶联免疫吸附法(ELISA)测定PCOS组与对照组患者血浆PAI-1及血清uPA水平,并测定体重指数(BMI)、腰臀比(WHR)、空腹血糖(FPG)、空腹胰岛素及胰岛素释放试验(IRT),以稳态模型公式评估胰岛素抵抗(IR),并计算胰岛素曲线下面积(AUC)。结果PCOS组与对照组相比,黄体生成素/卵泡刺激素(LH/FSH)、睾酮(T)、空腹血糖、稳态(HOMA)指数、AUC及PAI-1含量均显著升高(P<0.05)。其中,PCOS肥胖组与正常体重组相比,HOMA指数、AUC及PAI-1含量也显著升高(P<0.05)。在相关性分析中,PAI-1与HOMA指数、PAI-1与AUC、PAI-1与BMI、HOMA-IR与BMI均有显著相关性(P<0.0001)。结论胰岛素抵抗和肥胖是影响PCOS患者PAI-1水平升高的一个很重要因素,抗PAI-1的研究可能为多囊卵巢综合征的治疗提供一个新的方法。     

切应力作用下肾近端小管上皮细胞纤溶酶原激活物(tPA和uPA)表达的变化及意义

检测切应力作用下肾近端小管上皮细胞纤溶酶原激活物tPA和uPA mRNA表达的变化,探讨糖尿病肾病早期小管间质细胞外基质重塑的可能机制.用5 dyn/cm2和10 dyn/cm2的切应力处理肾近端小管上皮细胞(NRK-52E),作用时间分别为1、3和6 h,用RT-PCR法检测tPA及uPA mRNA的表达.结果表明:切应力呈大小和时间依赖性下调肾小管上皮细胞tPA及uPA mRNA的表达.在糖尿病肾病早期,高滤过引起的切应力增加可抑制肾近端小管上皮细胞tPA和uPA mRNA表达,导致肾小管间质纤维蛋白溶解活性降低,参与小管间质细胞外基质的重塑.     

胃癌组织中尿激酶型纤溶酶原激活剂及其受体基因表达和临床意义

目的：研究尿激酶型纤溶酶原激活剂（ｕＰＡ）及其特异受体（ｕＰＡＲ）与胃癌的关系及其在胃癌浸润转移中的作用。方法：采用ｃＤＮＡ－ｍＲＡＮ原位分子杂交技术,分别检测了６４例胃癌及其癌旁组织中ｕＰＡ和ｕＰＡＲｍＲＮＡ表达情况,同时结合病人的临床生物学指征进行分析。结果：癌与癌周比较,ｕＰＡ和ｕＰＡＲｍＲＮＡ阳性表达率明显升高,Ｐ〈０．００１。在伴有淋巴结转移的病例中,ｕＰＡ和ｕＰＡＲ阳性例数分别为１９／２９和２４／２９,与无转移的１０／３５和１３／３５相比,Ｐ分别〈０．０１和〈０．００１。在浸润到肌层、浆膜层的病例中ｕＰＡ和ｕＰＡＲ阳性例数分别为２５／３８和３０／３８,与浸润到粘膜和粘膜下层的４／２６例和７／２６相比,Ｐ均〈０．００１。在ｕＰＡ和ｕＰＡＲ同时阳性的病例中,伴有淋巴结转移和浸润到肌层以下的分别占１５／２     

Expression of urokinase-type plasminogen activator, urokinase-type plasminogen activator receptor, and plasminogen activator inhibitor-1 and -2 in hepatocellular carcinoma

It has become more and more clear in recent decades that the plasminogen activation system, which includes urokinase-type plasminogen activator (uPA), urokinase-type plasminogen activator receptor (uPAR), plasminogen activator inhibitor (PAI)-1 and PAI-2, plays a very important role in the aggressiveness of cancer. Using immunohistochemistry and enzyme-linked immunosorbent assay (ELISA), the expression of these four components of the uPA system was analyzed in 19 cases of hepatocellular carcinoma (HCC) and 18 cases of the adjacent non-cancer tissues which all had chronic active hepatitis with liver fibrosis or liver cirrhosis. Four cases of normal liver tissues, as controls for immunohistochemical stains, were obtained from the hepatectomized liver of patients with metastatic cancer in the liver. The positive rates of uPA, uPAR, PAI-1 and PAI-2 for immunohistochemical stains in cancer tissues were 78.9, 68.4, 57.9 and 31.6%, respectively. Positive signals were mainly distributed in the cytoplasm of the cancer and in stromal cells. Moreover, the strong stains were chiefly located in the invasive front of the cancer cells. No specific stain was detected in four cases of normal liver tissues. In ELISA, there were significant differences between cancer and non-cancer tissues in concentration of uPA, uPAR and PAI-1 (P < 0.0003, 0.0024 and 0.01, respectively), but there was no significant difference in that of PAI-2 (P = 0.37). These results suggest that uPA, uPAR and PAI-1 are related to invasion of HCC.     

基质金属蛋白酶3和尿激酶型纤溶酶原激活物受体在2型糖尿病大血管病变中的变化

目的： 探讨基质金属蛋白酶3（MMP-3）和尿激酶型纤溶酶原激活物受体（uPAR）在2型糖尿病大血管病变中的变化。方法: 用ELISA双抗体夹心法测定26例正常对照和39例2型糖尿病患者（其中单纯2型糖尿病15例、合并大血管病变24例）的血浆MMP-3和uPAR水平。结果: 单纯糖尿病组uPAR高于正常对照（P<0.05）而MMP-3无显著差异；合并大血管病变组MMP-3显著高于正常对照和单纯糖尿病组（P<0.01，P<0.01），而uPAR亦高于正常对照及单纯病变组（P<0.01，P<0.05）。2型糖尿病血浆MMP-3水平和uPAR水平呈正相关， LDL-C与uPAR呈正相关且是uPAR主要影响因素。 结论: MMP-3和uPAR与2型糖尿病大血管病变发生密切相关，MMP-3可作为2型糖尿病血管病变的循环标志物。     

尿激酶型纤溶酶原激活物受体及可溶性尿激酶型纤溶酶原激活物受体与炎症相关的研究进展

尿激酶型纤溶酶原激活物受体（urokinase plasminogen activator receptor,uPAR）与尿激酶型纤溶酶原激活物（urokinase plasminogen activator,uPA）同为纤溶酶原激活系统的主要成员,是一种协调多种信号转导途径的多功能分子,可溶性尿激酶型纤溶酶原激活物受体（soluble urokinase plasminogen activator receptor,suPAR）是其可溶形式。除凝血-纤溶以外,uPAR参与了肿瘤侵袭及炎症等多种疾病过程,而suPAR可能是一种良好的炎性标志物。本文就uPAR及suPAR在炎症中的作用进行简要综述。     

The urokinase-type plasminogen activator and inhibitors in resectable lung adenocarcinoma

BackgroundThe urokinase-type plasminogen activator (uPA) system is closely related to the occurrence and progression of cancer in many aspects. Previous studies demonstrated that the conclusions about the prognosis value of uPA, plasminogen activator inhibitor 1 (PAI-1) and plasminogen activator inhibitor 2 (PAI-2) in lung cancer are controversial, so this study was performed for the exploration of the predictive effect of uPA, PAI-1 and PAI-2 on the overall survival (OS) of resectable pulmonary adenocarcinoma patients.MethodsUPA, PAI-1 and PAI-2 expression levels were assayed by immunohistochemical staining based on tissue microarray (TMA) that is composed of formalin-fixed paraffin-embedded specimens from 84 resectable lung adenocarcinoma patients from July 2004 to June 2009. The relationship of IHC, mRNA expression levels of three molecules were investigated respectively. The three molecules’ relationship with clinicopathologic parameters and OS was explored by Chi-square, Kaplan-Meier, and Cox regression analyses. The Cancer Genome Atlas (TCGA) database was used to analyze differential gene expressions of RNA-sequencing data of pulmonary adenocarcinoma and normal tissues, and Kaplan-Meier methods were adopted to confirm the prognostic value of uPA, PAI-1 and PAI-2 in resectable lung adenocarcinoma in TCGA database and the R package MethylMix was used to conduct an analysis integrating methylation data and gene expression of RNA-sequencing data based on TCGA.ResultsUPA, PAI-1 and PAI-2 had much higher IHC expression levels in tumor than those in the normal tissues (uPA, Z = -10.511; PAI-1, Z = -4.836; PAI-2, Z = -6.794; all P < 0.0001). High DNA methylation level of gene uPA resulted in the decrease of its expression. In addition, expression level of PAI-2 was positively associated with tumor size (χ² = 8.372, P = 0.004). Multivariate analyses showed TNM stage III was an independent adverse prognostic factor (hazard ratio = 3.736, 95 % confidence interval = 1.097–12.72, P = 0.035). Kaplan-Meier method revealed that uPA, PAI-1 and PAI-2 expression levels were not related to the OS for 84 resectable lung adenocarcinoma patients. According to TCGA data, PAI-1 expression level was identified as a potential adverse predictor for prognosis of resectable lung adenocarcinoma (Gehan-Breslow-Wilcoxon test, P = 0.025).ConclusionsOur data show that, the expression levels of uPA, PAI-1 and PAI-2 are significantly up-regulated in resectable lung adenocarcinoma. Besides, this study highlights PAI-1 as a latent adverse prognostic factor in resectable adenocarcinoma of lung.     

慢性乙型肝炎或乙肝肝硬化重叠急性戊型肝炎临床特点分析

目的研究慢性乙型肝炎或乙肝肝硬化基础上重叠急性戊型肝炎（简称乙戊重叠）的临床特点及戊肝病毒（HEV）对乙肝病毒（HBV）的影响。方法将2002年12月至2006年12月解放军第三。二医院收治的所有625例戊肝患者分为急性戊肝组（AHE组，437例）和乙戊重叠组（S组，188例），并进一步将乙戊重叠组分为慢性乙肝重叠戊肝组（CHB＋AHE，130例）和乙肝肝硬化重叠戊肝组（LCB＋AHE，58例），回顾性分析其特点并对32例乙戊重叠患者急性期和恢复期的HBVDNA水平进行随访。结果与AHE组相比，s组的总胆红素水平、重型肝炎发生率、痊愈患者平均住院日和病死率均明显升高，而谷丙转氨酶、白蛋白和凝血酶原活动度均明显降低；而且LCB＋AHE组的TBil水平，并发症如腹水、腹膜炎、肝性脑病和糖代谢紊乱等的发生率要明显高于CHB＋AHE组。对32例s组患者随访发现，20例（62．5％）出现HBVDNA水平下降，平均下降值为2，1log10；6例（18．8％）HBVDNA始终阴性，4例（12，5％）HBVDNA无变化，2例（6，2％）HBVDNA轻度升高。结论乙戊重叠感染会导致患者病情加重，但HEV对于HBV的复制有一定的抑制作用。     

Expression of urokinase-type plasminogen activator receptor is increased during epileptogenesis in the rat hippocampus

Urokinase-type plasminogen activator receptor (uPAR) is functionally a pleiotropic mediator involved in cell adhesion, proliferation, differentiation and migration as well as in matrix degradation, apoptosis, and angiogenesis in cancer tissue. Comparable cellular alterations occur in the brain during post-injury tissue repair. As the first step to assess the role of uPAR in brain tissue remodeling, we tested a hypothesis that uPAR expression is altered in the hippocampus during epilepsy-related circuitry reorganization. Epileptogenesis was triggered by inducing status epilepticus (SE) with electrical stimulation of the amygdala in rats. To monitor the development of SE and the occurrence of spontaneous seizures animals were continuously video-EEG monitored until sacrificed (1, 2, 4 or 14 days after SE). The hippocampal expression of uPAR was studied with real time qPCR and immunohistochemistry. Double-immunohistochemistry and confocal microscopy were used to investigate the expression of uPAR in astrocytes, microglia and neurons. We show that in the normal hippocampus the expression of uPAR was low and confined to small population of astrocytes and interneurons. In animals undergoing SE, uPAR expression increased dramatically, peaking at 1 and 4 days after SE. According to double-immunohistochemistry, uPAR was highly expressed in parvalbumin positive interneurons in the hippocampus and dentate gyrus, and in a subgroup of somatostatin and neuropeptide Y positive hilar interneurons. Increased uPAR expression during post-injury phase supports its contribution to tissue remodeling in the brain. Surviving hilar interneurons that are known to be denervated due to loss of afferent inputs in post-SE brain provide a target for future studies to investigate the contribution of uPAR in reinnervation of these cells, and to identify the signaling cascades that mediate the effects of uPAR.     

Prognostic relevance of urokinase-type plasminogen activator (uPA) and plasminogen activator inhibitors PAI-1 and PAI-2 in gastric cancer

Expression of urokinase-type plasminogen activator (uPA), plasminogen activator inhibitor-1 (PAI-1) and plasminogen activator inhibitor-2 (PAI-2) was evaluated in 125 surgically resected gastric cancers by immunohistochemical analysis. Tissue was stained immunohistochemically with a monoclonal antibody against human uPA and monoclonal antibodies against human PAI-1 and PAI-2. In addition, DNA ploidy patterns were determined by cytofluorometer after staining with propidium iodide. We found that 82 (66%) of the 125 gastric cancers expressed uPA as diffuse cytoplasmic staining, as intensely outlined luminal borders. PAI-1 expression was observed in 62 (50%) of 125 gastric cancer as a fine, diffuse and granular pattern in the cytoplasm. PAI-2 expression was observed in 65 (52%) of the 125 gastric cancers as a diffuse cytoplasmic staining. uPA-positive tumours showed a higher incidence of infiltration, lymph node metastasis and peritoneal dissemination than uPA-negative ones. Patients with uPA-positive tumours proved to have a significantly poorer prognosis than those with negative ones. PAI-1-negative tumours showed a higher incidence of liver metastasis and carried a poorer prognosis than PAI-1-positive ones. There was no significant correlation between uPA or PAI-1 expression and DNA ploidy patterns. Conversely, there was no significant relationship between PAI-2 expression and clinicopathological parameters and prognosis. According to the expression of uPA and PAI-1 status, groups of 19 uPA(–)/PAI-1(–), 44 uPA(+)/PAI-1(–), 23 uPA(–)/PAI-1(+) and 39 uPA(+)/PAI-1(+) were subdivided. Tumours with UPA(+)/PAI-1(–) had a significantly higher incidence of liver metastasis, lymph node metastasis and serosal invasion than the other groups of tumours. Patients with uPA(+)/PAI-1(–) tumours had a significantly poorer prognosis than those with uPA(–)/PAI-1(+) tumours. These results indicate that uPA expression is a useful biological prognostic indicator, and that uPA and PAI-1 may play an important part in the tumour progression and metastasis in gastric cancer.     

Tissue-type plasminogen activator and its inhibitor in human glomerulonephritis.

We carried out an immunohistochemical study of tissue-type plasminogen activator (PA) and urokinase-type PA, and their inhibitors, PA inhibitor-1 and PA inhibitor-2, using renal biopsy specimens obtained from 86 patients with various forms of glomerulonephritis. The controls were four normal renal tissue specimens. On immunofluorescent observation, granular staining for tissue-type PA was found to be distributed along the glomerular capillary walls. The fluorescence was weak in the normal renal tissue and occasionally intense in the tissues of patients with IgA nephritis, minimal change nephrotic syndrome, and lupus nephritis. PA inhibitor-1 was abundant in the glomerular epithelial cells and scarce in the mesangial area and glomerular capillary lumens of the normal renal tissues. This was confirmed by immunoelectron microscopy using gold staining. The fluorescence of PA inhibitor-1 was weaker in some specimens of nephritic tissues than in the normal renal tissues. Urokinase-type PA and PA inhibitor-2 were negative within the glomeruli in all the specimens. In the glomerulonephritic tissues which were fibrin deposition-positive, tissue-type PA expression in the glomeruli tended to be strong. An association between fibrin deposition and PA inhibitor-1 staining was not clear. These data suggest that expression of tissue-type PA in the glomeruli increases in association with fibrin deposition.     

慢性乙型肝炎患者病毒基因型分布及与临床关系

目的了解邯郸市乙肝病毒基因型分布情况，并探讨其与临床的关系。方法采用PCR—RFLP方法对邯郸108份HBV感染者的血清进行基因型分型，并结合转氨酶和HBV—DNA结果，分析乙肝病毒基因型的临床意义。结果邯郸市慢性乙肝人群感染的HBV主要以C基因型为主，占93．5％，B基因型占6、5％。不同性别感染基因型差异无统计学意义。肝生化指标ALT、AST、TB比较提示c基因型患者的肝脏炎症似乎比B型患者重，但差异无统计学意义。C基因型的患者血清HBeAg阳性率高于B基因型。C基因型的患者血清HBV—DNA略高于B基因型，但无统计学差异。结论邯郸市慢性乙肝人群感染的HBV主要以C基因型为主。C基因型患者血清HBeAg阳性率高于B基因型，C基因型患者与B基因型相比肝脏炎症较重，HBV—DNA略高，但差异无统计学意义。