CAJ | 학술논문

目的研究Toll样受体(Toll-like receptor,TLRs)在重症肌无力(myasthenia gravis,MG)患者胸腺组织中的表达,分析其与MG发生、发展的关系.方法收集我科2007年7月至2008年2月手术治疗的36例MG患者胸腺标本,分为胸腺瘤组、瘤旁胸腺组、非瘤MG胸腺组,以无MG的正常胸腺21例为对照(正常胸腺组),采用逆转录-PCR技术,检测TLR2、TLR3、TLR4在胸腺组织中的mRNA转录表达水平,进一步采用实时定量逆转录-PCR检测TLR4 mRNA转录表达水平以及与MG临床特点间的关系.结果逆转录-PCR结果显示,TLR2 mRNA和TLR3 mRNA在4组之间的差别没有统计学意义,TLR4 mRNA的表达在4组之间的差别有统计学意义.进一步的实时定量逆转录.PCR检测TLR4 mRNA转录表达的结果显示,瘤旁胸腺组的TLR4 mRNA的表达比胸腺瘤组有明显的增加(0.8214±0.1019 vs 0.7101±0.0916,P=0.005),非瘤MG胸腺组TLR4 mRNA的表达量比正常胸腺组明显增加(0.8544±0.1200 vs 0.6851±0.1524,P=0.018),瘤旁胸腺组和非瘤MG胸腺组TLR4 mRNA的表达量之间的差别没有统计学意义,且都比正常胸腺组明显增加;TLR4 mRNA的表达与患者的Osserman分型呈正相关(R=0.609;P=0.004).结论 TLR4异常表达可能在MG发病中有重要作用,MG合并胸腺瘤患者瘤旁胸腺组织中TLR4的表达状态对胸腺瘤患者是否并发MG可能有重要影响.
목적 연구Toll양수체(Toll-like receptor,TLRs)재중증기무력(myasthenia gravis,MG)환자흉선조직중적표체,분석기여MG발생、발전적관계.방법 수집아과2007년7월지2008년2월수술치료적36례MG환자흉선표본,분위흉선류조、류방흉선조、비류MG흉선조,이무MG적정상흉선21례위대조(정상흉선조),채용역전록-PCR기술,검측TLR2、TLR3、TLR4재흉선조직중적mRNA전록표체수평,진일보채용실시정량역전록-PCR검측TLR4 mRNA전록표체수평이급여MG림상특점간적관계.결과 역전록-PCR결과현시,TLR2 mRNA화TLR3 mRNA재4조지간적차별몰유통계학의의,TLR4 mRNA적표체재4조지간적차별유통계학의의.진일보적실시정량역전록.PCR검측TLR4 mRNA전록표체적결과현시,류방흉선조적TLR4 mRNA적표체비흉선류조유명현적증가(0.8214±0.1019 vs 0.7101±0.0916,P=0.005),비류MG흉선조TLR4 mRNA적표체량비정상흉선조명현증가(0.8544±0.1200 vs 0.6851±0.1524,P=0.018),류방흉선조화비류MG흉선조TLR4 mRNA적표체량지간적차별몰유통계학의의,차도비정상흉선조명현증가;TLR4 mRNA적표체여환자적Osserman분형정정상관(R=0.609;P=0.004).결론 TLR4이상표체가능재MG발병중유중요작용,MG합병흉선류환자류방흉선조직중TLR4적표체상태대흉선류환자시부병발MG가능유중요영향.
Objective To investigate the expression ofToll-1ike receptors(TLRs)in thymus of myasthenia gravis(MG)patients and the relationship with clinical features.Methods Thymie specimens of 36 patients received extended thymectomy for MG were divided into three groups by pathological type:13 thymoma tissues(thymoma group) and 13 thymie tissues adjacent to thymomas(parathymoma group)from 13 eases of MG patients with thymomas,and 23 thymie tissues from MG patients without thymomas(MG nonthymoma group).Twenty-one normal thymic specimens from cardiac surgery were used as controls.The levels of TLR2-4 mRNA were examined by RT-PCR,then the levels of TLR4 mRNA were assayed by real time RT-PCR and their relationship with chnieal features were analyzed.Results The levels Of TLR4 mRNA among the different groups had significant differences,while there was no difference in TLR2 and nm levels.The real time RT-PCR showed that the level of TLR4 mRNA in nonthymoma group waft significantly higher than that in control group(0.8544t±0.1200 vs0.6851±0.1524.P=0.018).And SO is parathymoma group compared With thc thymoma group(0.8214±0.1019 Vs 0.7101±0.0916,P=0.005).No significant difference of TLR4A level was found between the parathymoma and nonthymoma groups.Nevertheless,the expression of TLR4 in both groups WaS increased compared with control group.The levels of TLR4 mRNA had positive correlation with Osserman type(R=0.609;P=0.004).Conclusion TLR4 may play a key role in the pathogenesis ofMG.It Was the thymie tissues sdjacent to thymomas but not thymomas themselves participated in the onset of MG.