慢性阻塞性肺病患者巨噬细胞功能与受体表达的关系研究

摘要

目的:研究慢性阻塞性肺病(COPD)患者气道巨噬细胞功能变化及其与受体表达的相关性.方法:将COPD患者84例按病情分为轻中度组44例,重度组40例,选取同期健康体检者40例作为对照组,获取3组诱导痰,分离痰巨噬细胞,检测3组吞噬荧光标记曲霉孢子的吞噬指数(PI),采用实时定量反转录PCR法检测3组吞噬相关受体的表达.结果:轻中度组与重度组细胞总数均多于对照组,而巨噬细胞比例却显著下降(P＜0.05);轻中度组与重度组巨噬细胞吞噬功能均受到抑制,3组PI比较差异有统计学意义(P＜0.05);3组巨噬细胞胶原结构清道夫系统(MARCO)、清道夫受体A1(SR-A1)表达量比较差异不明显(P＞0.05);轻中度组与对照组Toll样受体4(TLR4)表达量比较差异不明显,但重度组TLR4表达上调,与轻中度组、对照组比较差异有统计学意义(P＜0.05);3组MUC5A、AQP5表达量比较差异显著(P＜0.05);巨噬细胞PI与TLR4、黏蛋白5AC(MUC5A)表达量呈负相关(P＜0.05),与水通道蛋白5(AQP5)表达量呈正相关(P＜0.05).结论:COPD患者巨噬细胞占细胞总数的比例下降,其吞噬功能也受到抑制,其机制可能与TLR4、MUC5A表达上调及AQP5表达下调等有关.%Objective:To study airway macrophages function changes and its relationship with receptor expression in patients with COPD.Methods:84 patients with COPD in our hospital between January 2015 and March 2016 were divided into the mild-moderate group (44 cases) and the severe group (40 cases),and selected 40 healthy people as the control group.We obtained the induced sputum from the three groups,separated macrophage,and detected the phagocytic index (PI) of fluorescent taged aspergillus spores.Real-time quantitative reverse transcription PCR method was used to detect the expression of related genes of 3 groups.Results:The total number of cells in mild-to-moderate group and severe group were more than in the control group,but the macrophages ratio had dropped significantly (P＜0.05).All the phagocytosis of macrophage were restrained in mild-to-moderate group and severe group.PI of three groups had statistically significant difference (P＜0.05).The difference in expression quantity of Macrophage SR with collagenous structure (MARCO) and Scavenger receptor-A1 (SR-A1) had no statistical significance between the three groups (P＞0.05).Toll-like receptors-4 (TLR4) expression quantity in mild-to-moderate group showed no statistically significant difference,when compared with control group,but that in severe group was upregulated and had significant difference with those of the mild-to-moderate group and the control group (P＜0.05).MUC5A and AQP5 expression quantity also showed statistically significant differences between three groups (P＜0.05).Macrophages PI was negatively correlated with the expression quantity of TLR4 and MUC5A (P＜0.05),but positively correlated with the expression quantity ofAQP5 (P＜0.05).Conclusion:Patients with COPD had the proportion of macrophages decreased and the phagocytosis function restrained as more greatly as the disease was aggravating.Its mechanism may be related to the up-regulation of TLR4 and MUC5A expression and down-regulation of AQP5 expression.