复发性口疮病灶TNF/sTNFR失衡在其致病机制中意义

摘要

目的：为验证肿瘤坏死因子(TNF)及其可溶性受体(sTNFR)失衡导致复发性口疮发病的假说。方法：采用双抗体夹心酶联免疫法检测组织标本中TNFα、TNFβ及sTNFR 分泌水平，复发性口疮(RAU)活动期患者21 例作为研究组，无RAU 病史的口腔粘膜外伤23 人作对照组。结果：RAU 病灶中TNFα、TNFβ分泌水平明显高于对照组；RAU 粘膜病灶的sTNFR-Ⅱ水平明显高于对照组，但RAU 病灶中口腔粘膜固有层单个核细胞分泌sTNFR-Ⅱ并未升高。结论：RAU 患者的TNFα分泌增多，但其粘膜固有层单个核细胞分泌sTNFR-Ⅱ的数量并未相应升高。RAU 患者TNF 与TNF 天然抑制因子分泌失衡在其致病机制中占有重要意义。%Objective: To test the hypothesis that an imbalance of the expression of tumor necrosis factor(TNF) and TNF receptor(TNFR) plays a role in oral recurrent aphthous ulcer(RAU).Methods: TNFα, TNFβ and soluble TNF receptors(sTNFR) were measured with an enzyme linked immunosorbent assay using sandwich technique in the culture supernatants of oral mucosal RAU biopsy specimens and isolated lamina mononuclear cells from the lesion in 21 patients with active RAU. 23 patients with oral mucosa injury but without RAU history served as the controls. Results: Spontaneous secretion of TNFα and TNFβ (pg/mg) in RAU involved mucosa was higher than those in the control(39.2±12.3 vs 5.6±1.2 and 2.8±0.8 vs 1.4±0.3 respectively, P<0.01). sTNFR-Ⅱ(pg/mg) in RAU involved mucosa was heigher than that in the control(117.0±42.0 vs 61.0±12.0, P<0.01). TNF-α(μg/L) in mononuclear cells from the lamina of RAU involved mucosa was heigher than that from the control(38.26±3.53 vs 2.16±0.68).Conclusion: An imbalance of secretion of TNFs and sTNFR may play a role in the pathogenesis of RAU.