本文選題：幽門螺桿菌 + 緊密連接蛋白�。� 參考：《浙江大學(xué)》2013年碩士論文

【摘要】：研究背景： 胃黏膜具有阻止各種物理和化學(xué)物質(zhì)損傷的防御機(jī)制,包括黏液-碳酸氫鹽屏障、黏膜屏障、黏膜血流和上皮細(xì)胞更新。胃黏膜屏障主要由上皮細(xì)胞及細(xì)胞間連接組成,可有效防止H+的反向彌散,阻止大分子入侵,是防止有害微生物經(jīng)胃侵入機(jī)體的第一道防線。細(xì)胞間連接是由緊密連接、黏附連接、縫隙連接和橋粒等組成。一旦緊密連接受損,上皮細(xì)胞間的通透性增加,細(xì)菌、內(nèi)毒素等就可通過緊密連接進(jìn)入機(jī)體,這與多種疾病的發(fā)生發(fā)展有關(guān)。幽門螺桿菌(helicobacter pylori, Hp)感染與慢性胃炎、消化性潰瘍、胃腺癌和黏膜相關(guān)性淋巴組織淋巴瘤密切相關(guān),但其發(fā)病機(jī)制尚不清楚。研究表明,Hp產(chǎn)生的毒素和有毒素作用的酶能破壞胃黏膜屏障,還能使機(jī)體產(chǎn)生炎癥和免疫反應(yīng),導(dǎo)致疾病的發(fā)生。流行病學(xué)資料顯示,50%以上Hp相關(guān)疾病患者是在兒童期受到感染,Hp與兒童慢性胃炎、十二指腸炎、消化性潰瘍的發(fā)生發(fā)展密切相關(guān)。目前認(rèn)為,Hp感染后胃上皮屏障功能的受損在Hp相關(guān)性胃病的發(fā)病中起著重要的作用,有關(guān)兒童Hp感染對胃上皮屏障功能的影響尚不明了。因此,進(jìn)一步研究兒童Hp感染后胃黏膜緊密連接蛋白表達(dá)及其變化,對于了解Hp相關(guān)性胃病的發(fā)病機(jī)制有著重要的臨床意義。 目的： 探討Hp感染患兒胃黏膜緊密連接蛋白如咬合蛋白(occludin)、閉合蛋白(claudin)、閉合小環(huán)蛋白(ZO-1)、上皮型鈣黏蛋白(E-cadherin)和μ連環(huán)蛋白(β-catenin)表達(dá)的變化及其臨床意義。 方法： 收集2011年5月-11月因“惡心、嘔吐、腹痛、腹脹或反酸、黑便”等消化道癥狀在浙江大學(xué)醫(yī)學(xué)院附屬兒童醫(yī)院胃腸鏡室接受胃鏡檢查,所有研究均與家長簽署知情同意書,并符合醫(yī)學(xué)倫理原則。胃鏡檢查時在患兒胃竇部取3塊活檢組織,一塊用于快速尿素酶檢測,一塊固定于10%福爾馬林送檢病理,一塊液氮凍存后.80℃低溫冰箱中保存。胃黏膜緊密連接蛋白mRNA水平的測定采用RT-PCR法,其蛋白質(zhì)水平的測定采用Western blot法；E-cadherin和β-catenin在胃黏膜上皮的定位和半定量測定采用免疫組織化學(xué)法。 結(jié)果： 臨床病理資料完整的患兒共41例,其中男28例,女13例,年齡3.5-16歲。幽門螺桿菌尿素酶及病理檢測Hp陽性27例,Hp陰性14例。Hp陽性組中消化性潰瘍者13例,非潰瘍者14例。在Hp感染患兒的胃黏膜組織中無論有潰瘍組及無潰瘍組,ZO-1、E-cadherin、β-catenin mRNA表達(dá)水平低于Hp陰性組,差異有統(tǒng)計學(xué)意義(P均0.01)；claudin-4在Hp陽性潰瘍組表達(dá)明顯升高,差異有統(tǒng)計學(xué)意義(P0.01)；而occludin在三組間差異沒有統(tǒng)計學(xué)意義。免疫組織化學(xué)結(jié)果顯示,Hp陽性組患兒的E-cadherin、β-catenin蛋白表達(dá)水平低于陰性對照組,差異有統(tǒng)計學(xué)意義(P分別0.01和0.05)。 結(jié)論： Hp感染患兒胃黏膜緊密連接蛋白ZO-1、E-cadherin、β-catenin表達(dá)降低,消化性潰瘍患兒claudin-4表達(dá)增加,提示兒童Hp感染后胃上皮屏障功能受損可能是Hp相關(guān)性胃病的主要致病機(jī)制。
[Abstract]:Research background:
The gastric mucosa has a defense mechanism that prevents damage to various physical and chemical substances, including the mucous - bicarbonate barrier, the mucosal barrier, the mucosal blood flow and the epithelial cell renewal. The gastric mucosal barrier is composed mainly of epithelial cells and intercellular connections, which can effectively prevent the reverse dispersion of H+, prevent the invasion of large molecules, and prevent the harmful microorganism from invading through the stomach. The first line of defense in the body. Intercellular connections are composed of close connections, adhesion connections, gap junctions and bridging particles. Once the close connections are damaged, the permeability between the epithelial cells increases, bacteria, endotoxin and so on can enter the body through close connection, which is related to the development of a variety of diseases. Helicobacter pylori, H P) infection is closely related to chronic gastritis, peptic ulcers, gastric adenocarcinoma and mucosa associated lymphoid tissue lymphoma, but its pathogenesis is still unclear. Studies have shown that the toxins produced by Hp and enzymes that have toxic effects can destroy the gastric mucosal barrier, and can also cause inflammation and immune response to the disease. Epidemiological data have been shown to show. More than 50% of the patients with Hp related diseases are infected in childhood, and Hp is closely related to the development of chronic gastritis, duodenitis and peptic ulcers in children. It is now believed that the damage of the gastric epithelial barrier function after Hp infection plays an important role in the pathogenesis of Hp related gastropathy, and related to the function of Hp infection to the gastric epithelial barrier in children. Therefore, further study of the expression and changes of the close connexin in the gastric mucosa after Hp infection in children has important clinical significance for understanding the pathogenesis of Hp related gastropathy.
Objective:
The changes and clinical significance of the expression of close connexin (occludin), closed protein (claudin), closed small cyclic protein (ZO-1), epithelial Calc mucin (E-cadherin) and muon catenin (beta -catenin) in the gastric mucosa of children with Hp infection were investigated.
Method:
The digestive tract symptoms, such as "nausea, vomiting, abdominal pain, abdominal distention, or anti acid, and stool", were collected in the gastroenteroscopy room of the children's Hospital Affiliated to Zhejiang University Medical College, Zhejiang University, in May 2011. All the studies signed the informed consent with the parents and were in accordance with the principles of medical ethics. In the gastroscopy, 3 biopsy tissues were taken in the antrum of the children's stomach. Used for rapid urease detection, one was fixed in 10% formalin to be examined by 10% formalin, and one piece of liquid nitrogen was stored in cryogenic refrigerator after cryopreservation. RT-PCR method was used to determine the level of close connexin mRNA in gastric mucosa. The protein level was determined by Western blot; E-cadherin and beta -catenin were located and semi quantified in the gastric mucosa epithelium. The immuno histochemical method was adopted.
Result錛，

本文編號：2055588