肿瘤坏死因子相关凋亡诱导配体及其受体在特发性炎性肌病患者骨骼肌的表达

目的 通过检测TNF相关凋亡诱导配体(TRAIL)及其受体DR4、DR5、DCRI、DCR2在特发性炎性肌病(IIM)患者骨骼肌组织中的表达,探讨TRAIL系统在IIM发病机制的作用和意义.方法 选IIM患者肌活榆标本36份,其中多发性肌炎(PM)13份,皮肌炎(DM)23份,另选9份骨科外伤手术患者骨骼肌组织标本作对照.用免疫组化法检测TRAIL及其受体在对照组和IIM患者骨骼肌组织中的表达水平.结果 (I)对照组和IIM患者骨骼肌细胞上均有TRAIL及其受体DR4、DR5、DCR1、DCR2表达,IIM患者骨骼肌细胞上TRAIL、DR4、DCR2表达明显增加,与对照组相比,差异有统计学意义(P值均小于0.05).(2)IIM患者肌内膜和间质血管周围浸润的淋巴细胞以表达TRAIL和DCR1为主,少量表达DR4,未见DR5、DCR2表达.(3)有吞咽困难的患者病变肌组织TRAIL、DR4、DCR2表达水平明显升高.ESR升高的患者DCR2表达水平较高.结论 IIM患者受累肌组织中TRAIL及其受体的表达明显增加,提示TRAIL系统可能在IIM肌细胞损伤过程中发挥重要作用.

The expression of tumor necrosis factor-related apoptosis inducing ligand and its receptors in muscle tissue of inflammatory myopathies

Objective The purpose of this study is to analyse the expression of tumor necrosis factor (TNF)-related apoptosis inducing ligand(TRAIL)and its receptors in muscle tissue from patients with idiopathic inflammatory myopathies(ⅡM)and investigate the possible role of TRAIL system in the Dathogenesis of IIM.Methods TRAIL and its receptors DR4,DR5,DCRl and DCR2 were detected in the musck biopsy tissue from 36 patients with ⅡM(13 polymyositis,23 dermatomyositis)and 9 heMthy controls bv using immunohistochemistry. Results The expression of TRAIL and its receptors was f10und in muscle tissue samples from the IIM patients and healthy controls.The expression of TRAIL,DR4 and DCR2 in the muscle tissue from the IIM patients was significantly higher than those from healthy controls(all P values< 0.05).The expression of TRAIL,DCRl and DR4 was also detected in the infiltrating lymphocytes in endomysium and in the interstitial tissue around blood vessels.Conclusion The diversity in expression of TRAIL and its receptors between patients with IIM and healthy controls suggests the hypothesis of a crucial role of TRAIL in the pathogenesis and the pathology of IIM.