摘要
目的:嗜酸性粒细胞性肠炎(eosinophilic enteritis,EoN)的发病机制复杂,涉及多个细胞及分子,但尚未完全明确。本研究探讨EoN患儿小肠黏膜肠道3型固有淋巴细胞(type 3 innate lymphoid cells,ILC3)数量和IL-22表达的变化及其临床意义。方法:选取2020年6月至2021年12月确诊为EoN的20例患儿为EoN组,同期选取以腹痛、便血等为主诉,排除诊断EoN的20例患儿为对照组,行外周血嗜酸性粒细胞(eosinophil,EOS)计数及免疫球蛋白E(immunoglobulin E,IgE)水平测定,HE染色观察十二指肠及回肠黏膜EOS数量变化,免疫组织化学染色检测IL-22和ZO-1蛋白,免疫组织化学双染检测ILC3数量,real-time RT-PCR测定小肠黏膜IL-22、ZO-1 mRNA表达量,分析十二指肠及回肠黏膜ILC3细胞数量、IL-22含量与EOS数量、ZO-1含量的相关性。结果:EoN组患儿外周血EOS计数和总IgE水平均较对照组显著升高(均P<0.05);十二指肠及回肠黏膜EOS数量均较对照组明显增加(均P<0.05);十二指肠及回肠黏膜ILC3细胞数量和IL-22含量均较对照组显著减少,且均与对应部位黏膜EOS数量呈负相关,与ZO-1含量呈正相关(均P<0.05)。结论:小肠黏膜ILC3数量和IL-22含量减少,以及小肠黏膜屏障受损可能是EoN的发病机制之一。
Objective:The pathogenesis of eosinophilic enteritis(EoN)is complex and involves multiple cells and molecules,but remains incompletely understood.This study aims to investigate the changes in intestinal mucosal type 3 innate lymphoid cells(ILC 3)and interleukin-22(IL-22)expression in children with EoN and assess their clinical significance.Methods:A total of 20 children diagnosed with EoN between June 2020 and December 2021 were included in the EoN group.Another 20 children presenting with abdominal pain,hematochezia,or other symptoms but excluded from EoN diagnosis served as the control group.Peripheral blood eosinophil(EOS)counts and immunoglobulin E(IgE)levels were measured.HE staining was used to evaluate EOS infiltration in duodenal and ileal mucosa.Immunohistochemical staining was performed to detect IL-22 and ZO-1 protein expression,while dual immunohistochemical staining was used to quantity ILC 3 s.Real-time RT-PCR was conducted to assess IL-22 and ZO-1 mRNA expression.Correlations between ILC 3 counts,IL-22 levels,EOS counts,and ZO-1 levels in the mucosa were analyzed.Results:Peripheral EOS counts and total IgE levels in the EoN group were significantly higher than those in the control group(both P<0.05).EOS infiltration in the duodenal and ileal mucosa was significantly increased in the EoN group(P<0.05).The number of ILC 3 s and the levels of IL-22 in both duodenal and ileal mucosa were significantly reduced in EoN patients compared to controls.These were negatively correlated with EOS infiltration and positively correlated with ZO-1 levels(P<0.05).Conclusion:Reduced intestinal mucosal ILC 3 counts and IL-22 expression,as well as impaired mucosal barrier integrity,may contribute to the pathogenesis of eosinophilic enteritis in children.
作者
王丽媛
吴艳玲
汪陈慧
郑新国
胡艳翎
沈梦雨
杨辉
WANG Liyuan;WU Yanling;WANG Chenhui;ZHENG Xinguo;HU Yanling;SHEN Mengyu;YANG Hui(Department of Gastroenterology,Children’s Hospital Affiliated to Nanjing Medical University,Nanjing 210008,China)
出处
《临床与病理杂志》
2025年第2期168-176,共9页
Journal of Clinical and Pathological Research
