CAJ | 학술논문

目的探讨正常兔鼻腔黏膜对光动力疗法(photodynamic therapy,PDT)的反应性改变,为PDT用于治疗变应性鼻炎(allergic rhinitis,AR)做前期研究.方法取24只新西兰白兔,随机(随机数字表法)分为实验组和对照组,每组12只,实验组予以PDT干预,对照组做空白处理,分别于PDT处理后第1、3、7、14、21、28天取两组兔同一部位鼻黏膜,在光镜和透射电镜下观察鼻腔黏膜的组织形态学变化,并行免疫组织化学染色,观察三种速激肽类即P物质(SP)、神经激肽A(NKA)及神经激肽B(NKB)神经纤维的损伤情况.结果与对照组相比,PDT干预后,第1、3天可见鼻黏膜出现严重炎性反应,损伤至基底层,黏膜组织结构排列混乱,部分纤毛变短、畸形或缺失,各细胞器损伤明显;第7、14、21天可见纤毛细胞、柱状细胞及杯状细胞再生现象,基底细胞及固有层腺体增生,且腺体可见分泌现象;第28天时鼻黏膜重新覆盖纤毛柱状上皮,有少量微绒毛,杯状细胞内出现黏原颗粒.各阶段实验组兔鼻黏膜免疫组织化学染色显示三种神经肽均未表达.结论兔的正常鼻腔黏膜经过PDT干预后会出现可恢复性损伤,1周后鼻黏膜开始自行修复,约4周时除所观察的神经末梢外的其他结构和功能基本恢复正常.
목적 탐토정상토비강점막대광동력요법(photodynamic therapy,PDT)적반응성개변,위PDT용우치료변응성비염(allergic rhinitis,AR)주전기연구.방법 취24지신서란백토,수궤(수궤수자표법)분위실험조화대조조,매조12지,실험조여이PDT간예,대조조주공백처리,분별우PDT처리후제1、3、7、14、21、28천취량조토동일부위비점막,재광경화투사전경하관찰비강점막적조직형태학변화,병행면역조직화학염색,관찰삼충속격태류즉P물질(SP)、신경격태A(NKA)급신경격태B(NKB)신경섬유적손상정황.결과 여대조조상비,PDT간예후,제1、3천가견비점막출현엄중염성반응,손상지기저층,점막조직결구배렬혼란,부분섬모변단、기형혹결실,각세포기손상명현;제7、14、21천가견섬모세포、주상세포급배상세포재생현상,기저세포급고유층선체증생,차선체가견분비현상;제28천시비점막중신복개섬모주상상피,유소량미융모,배상세포내출현점원과립.각계단실험조토비점막면역조직화학염색현시삼충신경태균미표체.결론 토적정상비강점막경과PDT간예후회출현가회복성손상,1주후비점막개시자행수복,약4주시제소관찰적신경말소외적기타결구화공능기본회복정상.
Objective To study the reactive changes of normal nasal mucosa in rabbit under photodynamic therapy (PDT) and to make a preliminary research for the treatment of allergic rhinitis (AR) with PDT.Methods Twenty-four New Zealand rabbits were divided into 2 groups,an experimental group and a control group with 12 rabbits in each group.PDT was applied to the experimental group,while the control group was given no treatment.The nasal mucosa was sampled separately from the same position of the rabbits from the 2 groups on 1st,3rd,7th,14th,21st,28th day.Histomorphological changes of the sampled nasal mucosa were observed under light microscope and transmission electron microscope (TEM).The damage of three tachykinins:substance P (SP),neurokinin A (NKA) and neurokinin B (NKB) of nerve fibers was observed after immunohistochemical staining.Results Compared with the control group,the nasal mucosa tissues from the experimental group had serious inflammatory reaction with basal layer damaged on the 1st and 3rd day after PDT application,the epithelial cells of nasal mucosa were arranged in disorder,and part of cilium shortened and became abnormal or even disappeared,each organelles damaged obviously; on the 7th,14th,21st day,it could be seen that ciliated cell,columnar cell and goblet cell started regeneration,basal cell and lamina propria glands proliferated,and the glands appeared secretion phenomenon; on the 28th day,ciliated columnar epithelium took back the nasal mucosas with small amount of microvilli,and mucous granules were found in the column cells.Nasal immunohistochemical staining of the experimental group from various stages showed that three kinds of neuropeptides were not expressed.Conclusions Normal rabbit nasal mucosas will be temporarily damaged after PDT application,the damaged nasal mucosa begin to recover in one week,and return to normal in about four weeks.Most structure and functions have recovered at the fourth week except some nerve endings.