摘要
目的 探讨透析相关性淀粉样变 (DRA)关节滑膜单核 /巨噬细胞浸润的机制。方法关节组织取自 12例长期血透病人的尸检标本 ,用单克隆抗体免疫组化法观察滑膜组织各种黏附分子和趋化因子的表达 ,以 2例活动性类风湿性关节炎和 3例正常人滑膜组织作为阳性和阴性对照。结果 合并DRA的血透病人血管内皮细胞表达细胞间黏附分子 1(ICAM 1)和 (或 )血管细胞黏附分子 1(VCAM 1)、E 选择素 ,滑膜细胞表达ICAM 1和单核细胞趋化蛋白 1(MCP 1) ,多数血管周围浸润的单核细胞LFA 1和VLA 4阳性。黏附分子和MCP 1表达的部位和程度与DRA的病程及单核细胞浸润程度密切相关。无DRA的血透病人和正常人滑膜组织中无明显黏附分子和趋化因子表达。结论滑膜组织表达黏附分子和MCP 1是DRA时关节组织单核 /巨噬细胞浸润的可能机制。
Objective A local inflammatory reaction to β 2 microglobulin (β 2m) amyloid deposits by monocytes/macrophages is a characteristic histological feature of dialysis related amyloidosis (DRA) The study was therefore conducted to elucidate the mechanism of macrophage infiltration in the synovial tissue of DRA patients Methods Twelve patients with hemodialysis were submitted to post mortem studies The expression of cell adhesion molecules and chemokines in synovial tissue was determined by using immunohistochemical staining Results Vascular endothelial cells were strongly positive for VCAM 1 and E selectin in synovium obtained from DRA patients ICAM 1 and MCP 1 were expressed not only in endothelial cells but also in some of mononuclear cells and synovial cells In addition, most of the perivascular mononuclear cells were positive for LFA 1 and VLA 4 The expression of adhesion molecules and MCP 1 occurred mainly in patients with larger β 2m deposits (>0 2 mm 2) and those with marked infiltration of macrophages No significant expression of the adhesion molecules and MCP 1 was seen in synovia obtained from patients without DRA and normal subjects Conclusion Upregulated expression of adhesion molecules and MCP 1 in synovia is possibly involved in the tissue inflammatory reaction seen in DRA
出处
《中华内科杂志》
CSCD
北大核心
2000年第3期178-180,I006,共3页
Chinese Journal of Internal Medicine
