人增生性瘢痕组织内下丘脑—垂体—肾上腺皮质轴成分的表达

摘要

Objective To explore the expression and significance of secretions of hypothalamus-pituitary-adrenal (HPA) axis in human hypeorophic scar.Methods Hypertrphic scar tissues obtained from 12 patients with deep-partial thickness burn or full-thickness burn and normal skin tissues from the same 7 patients with hypertrophic scar were harvested for determination of gene expression of corticotrophinreleasing hormone (CRH),CRH receptor 1 (CRH-R1),pro-opiomelanocortin (POMC),melanocortin receptor 2 ( MC-2R),and glucocorticoid receptor α ( GR-α ) by real-time fluorecence quantitative PCR.After addition of corresponding antibodies,distribution differences of CRH,CRH-R1,adrenocorticotropic hormone ( ATCH ),MC-2R,and CR-α were observed with immunohistochemical staining,Data were processed with t test.Results The mRNA expression of CRH,CRH-R1,POMC,and GR-α in hypertrophie scar was respectively 3.1 ± 0.8,0.05 ± 0.03,0.020 ± 0.007,and 0.0030 ± 0.0010,which were significantly lower than those in normal skin ( 20.6 ± 4.7,0.30 ± 0.12,0.060 ± 0.020,and 0.0200 ± 0.0070,with t values from 2.10 to 4.75,P values all below 0.05 ).There was no statistical difference in MC-2R mRNA expression between hypertrophic scar and normal skin ( t=1.48,P =0.15).Immunohiatochemical observation showed CRH,CRH-R1,ACTH,MC-2R,and GR-α in hypertphic scar were located in basal layer of epidermis,fibroblast of dermis,and tube wall of sweat gland.Expressions of these indexes could also be observed in sebaceous gland and hair follicle besides above-mentioned structures.Conclusions Decreasing expression of active material of HPA axis may be related to formation of hypertrophic scar.%目的 探讨增生性瘢痕组织中下丘脑-垂体-肾上腺皮质(HPA)轴成分的表达及意义.方法 应用实时荧光定量PCR法,检测人增生性瘢痕(12例)和正常皮肤(7例)组织中HPA轴的活性物质促肾上腺皮质素释放激素(CRH)、促肾上腺皮质素释放激素受体1(CRH-R1)、阿片-促黑素细胞皮质素原(POMC)、黑素皮质素受体2(MC-2R)以及糖皮质激素受体α(GR-α)的mRNA表达差异,免疫组织化学法观察CRH、CRH-R1、促肾上腺皮质激素(ACTH)、MC-2R以及GR-α的分布差异.对数据进行独立样本t检验. 结果 PCR结果显示,增生性瘢痕组织标本中CRH、CRH-R1、POMC及GR-α的mRNA表达分别为3.1±0.8、0.05±0.03、0.020±0.007、0.0000±0.0010,均低于正常皮肤组织的20.6±4.7、0.30±0.12、0.060±0.020、0.0200±0.0070,差异有统计学意义(t值为2.10-4.75,P值均小于0.05)；但2种组织中MC-2R mRNA表达水平接近(t=1.48,P=0.15).免疫组织化学法检测结果显示,CRH,CRH-R1、ACTH、MC-2R以及GR-α分布于瘢痕组织的表皮基底层、真皮层的Fb和汗腺管壁中.在正常皮肤组织中阳性细胞除分布于上述部位外,还可见于毛囊和皮脂腺. 结论 增生性瘢痕形成与组织中HPA轴的活性物质表达降低有关.