目的：透析相关性淀粉样变（DRA）病人关节滑膜组织粘附分子表达增强，并与局 部炎细胞浸润密切相关。旨在探讨DRA时诱导滑膜细胞粘附分子表达上调的机制。 方法：分离正常人关节滑膜B型细胞，与晚期糖基化终产物修饰的β2微球蛋白（AGE-β2m） 、天 然β2m、肿瘤坏死因子-α（TNF-α）、白细胞介素-1β（ IL-1β）在体外共同培养 ，用荧 光单克隆抗体染色，流式细胞仪检测定量分析滑膜B型细胞表面细胞间粘附分子-1（ICAM- 1 ）、血管细胞间粘附分子-1（VCAM-1）、E-选择素（E-selectin）的表达。结果：正常关节 滑膜B型细胞表达ICAM-1、VCAM-1，但不表达E-selectin。IL-1β、TNF-α能以时间和 剂量 依赖的方式上调滑膜B型细胞ICAM-1、VCAM-1的表达，但无诱导E-selectin表达的作用。 AG E-β2m和β2m对B型细胞粘附分子的表达无直接影响。结论： DRA时关节组织存在的促炎 症细胞因子可能上调滑膜细胞粘附分子的表达，从而促使局部的单核细胞浸润。%Objective: Enhanced expression of adhesion molecules on synovial tissu e has been demonstrated in patients with dialysis-related amyloidosis (DRA). T he study was conducted to elucidate the mechanisms by which the expression of adh esion molecules on synovial cells was up-regulated.Methods: Human type-B synov ial cells were cultured in vitro with β2-microglobulin modified with adva nced glycation end products (AGE-β2m) , native β2-microglobulin (β2 m) , tumor necrosis factor-α（TNF-α）and interleukin -1β（ IL-1β）. The expression of intercellular adhesion molecule-1(ICAM-1), vasc ular cell adhesion molecule-1(VCAM-1), and E-selectin was examined by immunofluor esc enct staining and flow cytometer analysis. Results:ICAM-1 and VCAM-1, but not E -selectin, were constitutively expressed on human type-B synovial cells. TNF -α a nd IL-1β enhanced the expression of ICAM-1 and VCAM-1 in a dose- and time - depen dent manner. Neither of these cytokines appeared to induce the expression of E - selectin. Both β2m and AGE-β2m had no direct effect on the expression of the a dhesion molecules.Conclusion: Elevated level of IL-1β and TNF-α in the synov ial tissue may up-regulate the expression of adhesion molecules on synovial cel ls and therefore promote local monocytes infiltration.
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