叶内型肺隔离征肺部反复感染与基底干细胞增殖功能的关系

摘要

目的 通过研究叶内型肺隔离征(ILS)中基底干细胞的增殖情况探讨ILS的发病机制.方法 分别收集4例ILS患者的肺组织和4例健康对照肺组织.采用HE染色比较2组肺组织镜下病理改变,PAS染色比较2组肺组织气道杯状上皮细胞比例,免疫荧光染色及Real-time PCR法比较2组黏蛋白MUC5AC和MUC5B的分泌及表达,免疫荧光染色比较纤毛细胞的分布及基底细胞的增殖情况.结果 ILS组肺组织中充满炎性细胞并有气道上皮的损伤、气道杯状上皮细胞明显增殖、MUC5AC和MUC5B呈高分泌状态.角蛋白5(KRT5)在2组中差异无统计学意义,但增殖抗原KI67阳性(KI67+)/KRT5+细胞在ILS组明显减少.结论 通过增加气道上皮的增殖来修复并维持气道完整性为未来非外科治疗ILS提供了一个新方向.%Objective To investigate the proliferation potential of the basal stem cells in intralobar pulmonary sequestration syndrome (ILS) for revealing the pathogenesis of ILS. Methods In this study, lung tissue samples were collected from healthy control subjects(n=4)and abnormal lung lobes of ILS patients(n=4).The pathological changes were compared by HE staining between the two groups.The proportion of goblet cells was compared by PAS staining between the two groups.The expression and secretion of MUC5AC and MUC5B were compared by immunofluorescence staining and real-time PCR between the two groups. The distribution of ciliated cells and the proliferation of basal cells were compared by immunofluorescence staining between the two groups.Results The abnormal lobe of ILS group was filled with inflammatory cells, and the airway epithelium was disrupted. The airway goblet cells of ILS were obviously hyperplastic. The mucin proteins of MUC5AC and MUC5B were hypersecretion in the abnormal lobe of ILS patients.KRT5-positive basal stem cells proliferated only slightly in ILS patients, although there was no significant difference in KRT5 expression between two groups. Conclusion These data suggest that the pathogenesis of ILS may be associated with defects in basal stem cell function. Restoring airway integrity by targeting epithelial regeneration can be a future non-surgical treatment for patients with ILS.