血PAI-1和t-PA与多囊卵巢综合征的相关性研究

目的探讨多囊卵巢综合征（PCOS）患者的血纤溶酶原激活物抑制因子1（PAI-1）及组织纤溶酶原激活物（t-PA）在PCOS患者中的含量及其与PCOS发病的关系。方法应用酶联免疫吸附竞争法原理定量测定43例PCOS患者与20例健康体检者的PAI-1及t-PA的含量,根据体重指数将PCOS患者分为肥胖组（18例）和非肥胖组（25例）。结果PCOS组与正常对照组相比,PAI-1含量显著升高,t-PA含量下降,差异有显著性（P〈0.05）。其中,PCOS肥胖组与非肥胖组相比,HOMA指数、PAI-1含量也显著升高,差异有显著性（P〈0.05）。在相关性分析中,PAI-1与HO-MA指数有显著相关性（P〈0.0001）。结论PCOS患者PAI-1含量升高,t-PA含量下降,且与胰岛素水平有一定相关性。     

代谢综合征患者纤溶活性与胰岛素抵抗的关系

目的:探讨代谢综合征患者血浆纤溶活性及与胰岛素抵抗的关系。方法:选择单纯代谢综合征患者36例,代谢综合征合并冠心病患者44例和健康人群对照20例。观察一般情况,并测定血浆纤溶酶原激活抑制物-1(PAI-1)和组织型纤溶酶原激活物(t-PA)、纤维蛋白原(Fib)、空腹血糖(FBG)、空腹血胰岛素(Ins)和血脂等指标;计算胰岛素敏感指数(ISI)。结果:代谢综合征患者的ISI较正常对照组明显下降(P<0.05);血浆PAI-1、Fib等明显升高(P<0.05)。代谢综合征合并冠心病组PAI-1与Fib、Ins正相关,与ISI、高密度脂蛋白(HDL)负相关。结论:代谢综合征患者存在明显的胰岛素抵抗和纤溶活性异常,同时纤溶活性异常与胰岛素抵抗相关。     

尿激酶型纤溶酶原激活物及其特异受体和抑制物与肺癌的浸润转移

研究尿激酶型纤溶酶原激活物(uPA)及其特异受体(uPA-R)和抑制物(PAI-1、PAI-2)在肺癌浸润转移中的作用.应用RIA分别对67例经组织病理确诊的各期肺癌和30例肺部相关炎症患者及30名健康献血者进行了相应的检测.结果显示,小细胞肺癌Ⅱ期和Ⅲ期患者血浆中uPA、uPA-R、PAI-1水平显著升高(P＜0.001),而PAI-2的水平逐渐降低;腺癌、鳞癌伴有浸润主支气管及肺门淋巴结者uPA、uPA-R与PAI-1水平亦显著升高(P＜0.001);周围型肺癌未见淋巴结受侵者uPA、uPA-R、PAI-1与PAI-2水平异常升高.uPA、uPA-R与PAI-1在肺癌中水平明显升高,并与肺癌的浸润转移相关密切,可作为肿瘤患者早期诊断、预后评估的有力指标.     

PAI-1在多囊卵巢综合征大鼠脂肪组织中的表达及意义

目的 探讨纤溶酶原激活物抑制因子-l(PAI-1)在多囊卵巢及正常大鼠脂肪组织中的表达及在多囊卵巢综合征(PCOS)发病中的作用.方法 应用脱氢表雄酮(DHEA)皮下注射23 d龄SD雌性大鼠20天,建立PcOS大鼠模型,应用免疫组织化学技术对PAI-1在大鼠脂肪组织的表达强度变化进行研究.结果 PCOS大鼠模型建立成功;PAI-1在PCOS组脂肪组织基质细胞上的表达明显增强.结论 PAI-1在多囊卵巢大鼠发病中起着重要作用.     

胰岛素和葡萄糖对缺氧血管内皮细胞分泌tPA和PAI-1抗原的影响

目的: 观察胰岛素和葡萄糖对缺氧血管内皮细胞分泌组织型纤溶酶原激活物(tPA)及其抑制物-1(PAI-1)的影响。 方法:培养人脐静脉内皮细胞株ECV-304。分组实验:(1)常氧组;(2)在缺氧条件下又分为Ⅰ:缺氧对照组;Ⅱ:低浓度组:胰岛素150 mU/L、葡萄糖5.5 mmol/L;Ⅲ:中浓度组:胰岛素450 mU/L、葡萄糖15 mmol/L;Ⅳ:高浓度组:胰岛素900 mU/L、葡萄糖30 mmol/L;Ⅴ:渗透压对照组:甘露醇24.5 mmol/L。取培养4、8、12 h 3个时点,用ELISA法测定细胞培养上清液tPA、PAI-1抗原。结果:缺氧明显增加tPA和PAI-1抗原分泌,tPA/PAI-1值明显增加(P＜0.01)。胰岛素和葡萄糖能够刺激缺氧内皮细胞分泌tPA和PAI-1抗原,在缺氧8 h以内,tPA/PAI-1比值明显增加(P＜0.05)。随缺氧时间的延长,tPA/PAI-1值逐渐下降。结论:胰岛素和葡萄糖能够刺激内皮细胞分泌tPA和PAI-1抗原,在缺氧8 h以内,tPA/PAI-1值升高,纤溶活性升高,有利于局部自发性纤溶的发生。此作用可能是IGK治疗急性心肌梗死的机制之一。     

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。     

体外培养的血管内皮细胞低氧低糖损伤后tPA、PAI-1表达变化

目的：观察体外培养的血管内皮细胞低氧低糖损伤后组织型纤溶酶原激活剂(tPA)、Ⅰ型纤溶酶原激活物抑制因子(PAI-1)表达变化，探讨脑缺血后纤溶系统的变化及机制。材料和方法：制备体外内皮细胞低氧低糖损伤模型，利用HE染色、免疫细胞化学染色观察tPA、PAI-1表达变化。结果：低氧低糖损伤后，tPA、PAI-1表达均明显增强。结论：成功制备体外内皮细胞低氧低糖损伤模型。内皮细胞低氧低糖损伤可以诱导tPA、PAI-1表达增多，进一步说明脑缺血损伤后tPA、PAI-1表达增加并参与损伤过程。     

纤溶酶原激活物抑制因子-1蛋白分子的结构与功能

纤溶酶原激活物抑制因子-1(PAI-1)是组织型纤溶酶原激活物(t-PA)和尿型纤溶酶原激活物(u-PA)的特异性抑制剂。对PAI-1分子的结构与功能的认识,有助于了解PAI-1发挥抑制 作用的机理。本文综述了近年来对PAI-1蛋白分子结构与功能研究的进展,介绍了PAI-1分子中一些区域的作用以及影响PAI-1抑制活性的一些因子。     

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.     

妊娠高血压综合征患者vWF、t-PA、PAI-1的检测分析

目的:探讨妊娠高血压综合征(妊高征)患者内皮细胞功能指标的变化及其临床意义。方法:应用ELISA法及发色底物法测定妊高征患者血浆血管性血友病因子(vWF)、织织型纤溶酶原激活物(t-PA)及纤溶酶原激活抑制物-1(PAI-1)活性。结果:妊高征患者vWF、t-PA、PAI-1较正常非孕组明显升高(P<0.05或P<0.01);妊高征各组患者vWF、PAI-1活性比正常晚孕组显著增高(P<0.05或P<0.01),且病情越重增高越明显;t-PA无明显改变。中、重度妊高征组血浆vWF与PAI-1水平呈直线正相关关系(r=0.723,P<0.05;r=0.765,P<0.05)。结论:妊高征患者内皮细胞功能异常,凝血及纤溶抑制功能亢进。测定血浆vWF和PAI-1水平,对于临床诊断妊高征有重要意义。     

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.     

胃癌中uPA、PAI-1表达及其与血管生成的关系

目的 观察胃癌组织中uPA、PAI-1mRNA及蛋白的表达，并探讨它们与肿瘤分化、血管生成及临床病理因素之间的关系。方法 用原位杂交及免疫组化S-P法检测110例胃癌组织中uPA、PAI-1的表达，根据CD34阳性的血管内皮细胞计数肿瘤组织微血管密度（MVD）。结果 （1）胃癌组织中uPA mRNA和蛋白、PAI-1 mRNA和蛋白阳性表达定位于胞质；uPA的表达随分化程度的降低有逐渐升高的趋势，PAI-1的表达随分化程度的降低有逐渐降低的趋势。（2）110例uPA mRNA及蛋白表达阳性组MVD值显著高于阴性组，差异均具有显著性（P值均＜0．05）。（3）uPA mRNA及蛋白的表达与临床分期呈正相关（P＜0．05），PAI-1的表达与临床分期和淋巴结转移无相关性。（4）uPA mRNA／蛋白与PAI-1 mRNA／蛋白的表达无相关性。结论uPA与促进胃癌的血管生成密切相关，阻断uPA的分泌和作用途径有望对胃癌浸润转移起抑制作用；胃癌组织中PAI-1可能担当重要的调节剂或者是肿瘤细胞防止自身降解的保护剂而不是这个系统的单纯抑制剂。     

慢性肾脏疾病血清和尿液纤溶活性物质的改变及临床意义

目的探讨慢性肾脏疾病血清和尿液纤溶活性物质的改变及其临床意义。方法选择38例慢性肾小球肾炎(CGN),28例肾病综合征(NS),36例非透析治疗的慢性肾功能不全(CRF)和20例正常对照作为研究对象,应用ELISA法检测血清和尿液中组织型纤溶酶原激活剂(t-PA)和纤溶酶原激活物抑制剂-1(PAI-1)的浓度,同时分析尿中t-PA和PAI-1的水平与血t-PA、PAI-1、血肌酐和24h尿蛋白总量之间相关性。结果慢性肾脏疾病出现血清t-PA、PAI-1升高,尿液t-PA、PAI-1降低,其中尿液t-PA、PAI-1的改变独立于血清,不受血肌酐和24h尿蛋白定量的影响。结论慢性肾脏疾病患者存在纤溶活性物质的异常,其中尿液纤溶活性物质的改变可反应肾脏内皮细胞损伤。     

Insulin resistance, insulin sensitization and inflammation in polycystic ovarian syndrome

It is estimated that 5-10% of women of reproductive age have polycystic ovarian syndrome (PCOS). While insulin resistance is not part of the diagnostic criteria for PCOS, its importance in the pathogenesis of PCOS cannot be denied. PCOS is associated with insulin resistance independent of total or fat-free body mass. Post-receptor defects in the action of insulin have been described in PCOS which are similar to those found in obesity and type 2 diabetes. Treatment with insulin sensitizers, metformin and thiazolidinediones, improve both metabolic and hormonal patterns and also improve ovulation in PCOS. Recent studies have shown that PCOS women have higher circulating levels of inflammatory mediators like C-reactive protein, tumour necrosis factor-alpha, tissue plasminogen activator and plasminogen activator inhibitor-1 (PAI-1). It is possible that the beneficial effect of insulin sensitizers in PCOS may be partly due to a decrease in inflammation.     

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.