特发性肺纤维化患者肺泡和支气管上皮细胞凋亡及相关信号表达

目的探讨细胞凋亡和促凋亡信号在特发性肺纤维化（IPF）发生中的意义。方法应用末端原位杂交和免疫组化技术，检测12例IPF的肺活检组织和10例正常对照肺组织肺泡和支气管上皮细胞凋亡、P53、Fas抗原和Fas配体（Fas／FasL）蛋白表达的变化。结果IPF肺组织的肺泡和支气管上皮细胞凋亡率（12／12）明显高于对照组（0／10），IPF组肺泡上皮细胞中Fas、FasL、P53蛋白表达的阳性率（分别为12／12、12／12、11／12）均明显高于对照组（分别为5／10、2／10、0／10）。IPF组支气管上皮细胞中Fas、FasL、P53蛋白表达的阳性率（分别为12／12、12／12、11／12）也均明显高于对照组（分别为6／10、3／10、0／10）。相关分析结果表明，肺泡和支气管上皮细胞Fas／FasL、P53蛋白表达与其凋亡百分率之间均呈显著正相关（r值为0．625—0．839，P均〈0．01），肺泡和支气管上皮细胞Fas／FasL与P53蛋白表达之间也均呈显著正相关（r值为0．571～0．760，P均〈0．01）。结论肺纤维化时肺泡和支气管上皮细胞凋亡率增高，P53、Fas／FasL蛋白表达增强，这些因素在肺纤维化的发生和发展中起重要作用。

Cell apoptosis and the associated signal expression in epithelial cells from patients with idiopathic pulmonary fibrosis

OBJECTIVE: To investigate the changes and significance of cell apoptosis, Fas/FasL and P53 protein in epithelial cells from patients with idiopathic pulmonary fibrosis (IPF). METHODS: Cell apoptosis and the expressions of Fas/FasL and P53 protein in lung tissues from 12 patients with IPF (IPF group) and 10 normal controls (control group) were detected by terminal deoxynucleotide transferase-mediated deoxyuridine triphosphate-biotin nick end-labeling (TUNEL) and immunohistochemistry. RESULTS: Compared with the control group (0/10), the percentage of apoptosis in alveolar epithelial cells and bronchial cells of the IPF group (12/12) was higher. The percentage of Fas, FasL and P53 protein expressions (12/12, 12/12, 11/12) in alveolar epithelial cells of the IPF group were higher than those of the control group (5/10, 2/10, 0/10); and the percentage of Fas, FasL and P53 protein expressions (12/12, 12/12, 11/12) in bronchial cells of the IPF group were also higher than those of the control group (6/10, 3/10, 0/10). There was a significant correlation between the percentage of apoptosis and Fas/FasL and P53 protein expression (r=0.625-0.839, all P<0.01). The correlation of the Fas/FasL and P53 protein expression was also significant (r=0.571-0.760, all P<0.01). CONCLUSION: The apoptosis percentage of epithelial cells and the expression of Fas/FasL and P53 protein are up-regulated in lung tissues of IPF, which may play an important role in the development of the disease.