支气管扩张症中神经内分泌免疫网络及肥大细胞的变化

目的：探讨支气管扩张症中神经内分泌免疫网络的异常和肥大细胞（MC）在该病发病中的作用及关系。方法：应用组织化学、免疫组化、组织化学与免疫组化结合的方法和形态计量学方法进行观测。结果：支气管扩张症中，支气管上皮蛙皮素（Bombesin）阳性细胞、固有膜S-100蛋白和神经特异性烯醇化酶（NSE）阳性神经纤维、IgE阳性细胞、MC和IgE阳性MC均显著增多，且在支气管相关淋巴组织（BALT）增生的区域上述肺内分泌细胞、神经纤维和IgE阳性细胞增多尤为显著，S-100蛋白和NSE阳性神经纤维分布于弥散淋巴组织和BALT中，MC与S-100蛋白阳性神经纤维紧密接触．MC表面有IgE阳性环状带，MC和IgE阳性细胞出现在支气管上皮间和肺泡壁。结论：支气管扩张症的发病与局部神经内分泌免疫网络异常有关；MC可能作为感受器、分泌细胞或靶细胞参与神经内分泌免疫网络，在支气管扩张症的发病中起重要作用。

Study on the Changes of Neuroendocrine-Immune Network and Mast Cells in Bronchiectasis

Objective: To study the effects of abnormal neuroendocrine-immune network and mast cells in the pathogenesis of bronchiectasis. Methods: Histochemistry, immunohistochemistry, histochemistry combined with immunohistochemistry technique and morphometric analysis were used in this study. Results: The numbers of Bombesin positive pulmonary cells, the lamina propria S-100 protein, neuron-specific enolase (NSE) positive nerve fibers, IgE positive cells, mast cells and IgE positive mast cells significantly increased in bronchiectasis. The changes of pulmonary endocrine cells, nerve fibers and IgE positive cells were more significantly in hyperplastic BALT areas. The S-100 and NSE were found in lymphoid tissue and BALT. A close contact was found between mast cells and the S-100 positive nerve fibers. An IgE positive outer zone was found on MC surface. Mast cells and IgE positive cells were seen in the bronchial epithelium and alveolar septa. Conclusion: Pulmonary neuronendocrine-immune network abnormalities might play an important role in the pathogenesis of bronchiectasis. Mast cells may involve in the neuroendocrine-immune network as sensors, secretory cells or target cells and play an important part in the pathogenesis of bronchiectasis.