本文選題：尖銳濕疣 + Toll樣受體��； 參考：《中國(guó)醫(yī)科大學(xué)》2010年碩士論文

【摘要】： 研究背景 尖銳濕疣(Condyloma Acuminatum, CA)是主要由感染人乳頭瘤病毒(Human Papilloma Virus, HPV)引起人生殖器部位及附近表皮的一種良性乳頭瘤樣增生性疾病,典型病理改變是表皮中上層出現(xiàn)空泡細(xì)胞。CA治療并不困難,但由于復(fù)發(fā)率很高,且發(fā)病率逐年上升而逐漸引起人們的重視。目前普遍認(rèn)為,CA的發(fā)生、轉(zhuǎn)歸與機(jī)體免疫功能變化有關(guān)。CA患者機(jī)體免疫系統(tǒng)受抑制,尤其是細(xì)胞免疫功能低下是HPV進(jìn)入機(jī)體后長(zhǎng)期持續(xù)大量復(fù)制的主要原因。 Toll樣受體(Toll-like receptor, TLR)是新近發(fā)現(xiàn)的一類(lèi)模式識(shí)別受體,廣泛分布于細(xì)胞表面參與病原微生物及其產(chǎn)物的識(shí)別,并通過(guò)誘導(dǎo)活性氧中間產(chǎn)物和活性氮中間產(chǎn)物的產(chǎn)生、前炎癥因子的釋放實(shí)現(xiàn)病原微生物的清除和機(jī)體免疫狀態(tài)的調(diào)節(jié)。它們不僅在天然免疫中起重要作用,同時(shí)也被視為天然免疫與獲得性免疫的連接點(diǎn),影響獲得性免疫。Toll樣受體在CA發(fā)病機(jī)理中的作用已受到了越來(lái)越多的關(guān)注。在已發(fā)現(xiàn)的11種TLR家族成員中,TLR3和TLR9被認(rèn)為是抗病毒免疫的重要受體之一。本研究通過(guò)觀察不同預(yù)后CA患者皮損局部TLR3和TLR9的表達(dá)情況,試圖從一個(gè)新的角度反映CA患者機(jī)體免疫狀態(tài),以期找到更好的治療方式有效清除HPV,改善CA預(yù)后。 目的 通過(guò)觀察不同預(yù)后CA患者皮損局部TLR3和TLR9的表達(dá)情況,探討TLR3和TLR9在CA發(fā)病機(jī)制中的作用以及它們與CA發(fā)生、發(fā)展的關(guān)系。 方法 選擇CA患者24例(其中無(wú)復(fù)發(fā)者14例,復(fù)發(fā)者10例)及正常對(duì)照者10例,應(yīng)用免疫組化法及RT-PCR法分別檢測(cè)各組CA組織和正常對(duì)照包皮組織中TLR3、TLR9的表達(dá)情況。所有數(shù)據(jù)以x±s表示,采用SPSS13.0統(tǒng)計(jì)軟件進(jìn)行數(shù)據(jù)分析,兩組間比較采用獨(dú)立樣本t檢驗(yàn),P0.05具有統(tǒng)計(jì)學(xué)意義。 結(jié)果 1、免疫組化定位分析：TLR3、TLR9蛋白定位于角質(zhì)形成細(xì)胞的胞漿和(或)胞膜。對(duì)照組TLR3、TLR9于表皮全層呈中等強(qiáng)度或弱表達(dá)；無(wú)復(fù)發(fā)組TLR3、TLR9于表皮全層強(qiáng)陽(yáng)性表達(dá),以棘層、顆粒層為主；復(fù)發(fā)組TLR3、TLR9于表皮全層中等強(qiáng)度表達(dá),以基底層、棘層為主。 2、RT-PCR半定量分析：無(wú)復(fù)發(fā)組TLR3、TLR9 mRNA與對(duì)照組相比表達(dá)升高(P0.01；P0.05),且無(wú)復(fù)發(fā)組TLR3的表達(dá)明顯高于TLR9 (P0.05);復(fù)發(fā)組TLR3、TLR9與對(duì)照組相比無(wú)明顯差異(二者均P0.05),與無(wú)復(fù)發(fā)組相比TLR3減少顯著(P0.05)。 結(jié)論 1、TLR3與TLR9在無(wú)復(fù)發(fā)組CA皮損局部表達(dá)上調(diào)； 2、TLR3與TLR9在復(fù)發(fā)組CA皮損局部的表達(dá)與對(duì)照組相比無(wú)顯著性差異(P0.05),較無(wú)復(fù)發(fā)組的表達(dá)有不同程度減少,其中TLR3減少有顯著性差異(P0.05)； 3、TLR3與TLR9的表達(dá)部位在無(wú)復(fù)發(fā)CA與復(fù)發(fā)CA組織中存在差異； 4、TLR3與TLR9的表達(dá)部位和表達(dá)量的改變可能與CA預(yù)后有關(guān),且TLR3的影響可能更大。
[Abstract]:Background Condyloma acuminatum (CA) is a benign papillomatous disease mainly caused by human papilloma virus (HPV). The typical pathological change is that it is not difficult to treat the vacuole cells in the upper and middle epidermis, but the recurrence rate is very high, and the incidence rate is increasing year by year, so people pay more and more attention to it. At present, it is generally believed that the occurrence and outcome of CA is related to the changes of immune function of the body. The immune system of patients with CA is suppressed. In particular, the low cellular immune function is the main cause of HPV replication. Toll-like receptor (TLR) is a new type of pattern recognition receptor. It is widely distributed on the surface of the cells involved in the recognition of pathogenic microorganisms and their products, and by inducing the production of reactive oxygen species intermediate products and active nitrogen intermediates, the release of proinflammatory factors can achieve the clearance of pathogenic microorganisms and the regulation of the immune state of the organism. They not only play an important role in innate immunity, but also are regarded as the junction point between innate immunity and acquired immunity. The role of .Toll-like receptors in CA pathogenesis has been paid more and more attention. TLR3 and TLR9 are considered as one of the important antiviral immune receptors among 11 TLR family members. In this study, we observed the expression of TLR3 and TLR9 in lesions of CA patients with different prognosis, and tried to reflect the immune status of CA patients from a new perspective, in order to find a better treatment to effectively remove HPVand improve the prognosis of CA. Objective to investigate the role of TLR3 and TLR9 in the pathogenesis of CA by observing the expression of TLR3 and TLR9 in lesions of CA patients with different prognosis. Methods 24 cases of CA (14 cases without recurrence, 10 cases of recurrence) and 10 cases of normal control were selected. The expression of TLR3 and TLR9 in CA tissues and normal prepuce tissues were detected by immunohistochemistry and RT-PCR respectively. All the data were expressed as x 鹵s and analyzed by SPSS 13.0 statistical software. The comparison between the two groups was statistically significant by using independent sample t-test (P0.05). Results 1. Immunohistochemistry analysis showed that the protein of TLR3 and TLR9 was located in cytoplasm and / or membrane of keratinocytes. In the control group, TLR3 + TLR9 was moderately or weakly expressed in the whole epidermis, TLR3 + TLR9 was strongly expressed in the whole epidermis, mainly in the spinous layer and granular layer, and TLR3 + TLR9 was expressed in the basal layer in the whole epidermis, and TLR3 + TLR9 was expressed in the basal layer of the epidermis. 2Semi-quantitative analysis by RT-PCR: the expression of TLR3nTLR9 mRNA in non-recurrence group was higher than that in control group (P0.01). The expression of TLR3 in non-recurrence group was significantly higher than that in TLR9 group (P0.05), but the expression of TLR3 in relapsing group was not significantly different from that in control group (P0.05), and the expression of TLR3 in non-recurrence group was significantly lower than that in non-recurrence group (P0.05). Conclusion 1the expression of TLR3 and TLR9 in CA lesions without recurrence was up-regulated; 2the expression of TLR3 and TLR9 in recurrent CA lesions was not significantly different from that in control group (P0.05), but the expression of TLR3 was lower than that of non-recurrence group (P0.05). 3There were differences between the expression sites of TLR3 and TLR9 between recurrent CA and non-recurrent CA, and the changes of expression and expression of TLR3 and TLR9 might be related to the prognosis of CA, and the effect of TLR3 might be more significant.
【學(xué)位授予單位】：中國(guó)醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2010
【分類(lèi)號(hào)】：R752.53

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