丁型肝炎病人肝组织HDAg与bcl-2、bax、bak表达关系

目的探讨bcl-2、bax、bak在丁型肝炎发病机制中的作用.方法采用免疫组化单、双标记染色技术等,检测77例各型丁肝病人肝组织中HDAg、bcl-2、bax和bak表达.以HDV阴性的67例乙型肝炎作对照.结果 bcl-2、bax和bak均以肝细胞浆表达为主.HDAg以肝细胞核表达为主.HDAg与bax和bak表达及分布有相关性,四成分在各型肝炎中的表达强度有显著性差别(P<0.05).结论 HDAg、bax、bak表达强度和阳性细胞分布均与肝组织炎症活动及病理损害程度相关,HDV感染可诱导肝细胞表达bax和bak,增强肝细胞凋亡,这一机制在丁型肝炎发病机制中可能有一定的重要作用.

Relationship of expressions of bcl-2, bax and bak with HDAg in tissues of hepatitis D patients

Objective To study the roles of apoptosis genes bcl 2, bax, and bak in the pathogenesis of hepatitis D. Methods Expressions of HDAg, bcl 2, bax, and bak in liver specimens of 77 patients with hepatitis D were studied by immunohistochemical method. Meanwhile, the relationship of HDAg expression with the expressions of bcl 2, bax, and bak was studied by double labelling. Results Bcl 2 was mainly expressed in the cytoplasm of hepatocytes, and bax and bak mainly in the cytoplasm of hepatocytes and partly in the nucleus of hepatocytes, and HDAg mainly in the nucleus of hepatocytes. Lots of HDAg and bax/bak positive cells were distributed in infiltrating lymphocytes at the periportal region especially at the advancing edges of areas of piecemeal necrosis. Apoptosis of many hepatocytes was found to locate near the HDAg positive cells. There was positive correlation between the expression of bax/bak and HDAg expression ( P <0.01, P <0.05). Conclusion The distribution and the expressions of bax/bak and HDAg are closely associated with the activity of inflammation and the severity of the liver damage. HDV infection may induce the expressions of bax and bak in the hepatocytes. Apoptosis caused by bcl 2 and bax/bak may play an important role in the liver cell injury caused by HDV infection.