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目的:探讨CTLA-4在慢性扁桃体炎发病中的作用,从炎症免疫反应软调节的角度为慢性扁桃体炎的药物治疗提供新的可能和理论依据。方法:从接受扁桃体全切术的患者中收取21例慢性扁桃体炎患者的扁桃体标本作为实验组,以15例扁桃体生理性肥大患者的扁桃体标本作为对照组。用苏木精-伊红染色法观察2组扁桃体组织的病理改变,用免疫荧光技术检测CTLA-4在2组中的表达差异和分布特征,用荧光定量PCR实验检测CTLA-4mRNA在2组中的相对表达定量。结果:苏木精-伊红染色显示实验组扁桃体病理结构以滤泡增生和生发中心的变化为主要特征,对照组发现有明显的“星空”现象;免疫荧光结果显示,实验组扁桃体组织中CTLA-4的平均荧光强度和密度明显高于对照组(P<0.05);荧光定量PCR实验结果显示,实验组CTLA-4mRNA的相对表达量显著高于对照组(t=6.294,P<0.01)。结论:CTLA-4在慢性扁桃体炎的发展中起重要作用,说明慢性扁桃体炎症的转归过程中可能存在免疫抑制的机制。扁桃体淋巴组织存在免疫抑制,为临床上扁桃体反复发炎的现象提供了新的解释,同时为慢性扁桃体炎的临床治疗提供了除手术以外从免疫学角度研发新的治疗药物的可能性。
OBJECTIVE: To investigate the role of CTLA-4 in the pathogenesis of chronic tonsillitis and provide new possibilities and theoretical basis for the drug treatment of chronic tonsillitis from the perspective of the soft-regulation of inflammatory immune response. Methods Twenty tons of tonsil specimens of patients with chronic tonsillitis were collected from patients who underwent total tonsillectomy as the experimental group and tonsil specimens from 15 tonsil hypertrophy patients as the control group. The histopathological changes of tonsil tissue were observed by hematoxylin-eosin staining. The expression differences and distribution characteristics of CTLA-4 in two groups were detected by immunofluorescence. The expression of CTLA-4 mRNA in two groups was detected by real-time PCR. The relative expression of quantitative. Results: Hematoxylin-eosin staining showed that the histopathology of tonsil in the experimental group was mainly characterized by follicular hyperplasia and germinal center. The “starry sky” phenomenon was found in the control group. The results of immunofluorescence showed that the tonsil tissue The average fluorescence intensity and density of CTLA-4 were significantly higher than that of the control group (P <0.05). The results of real-time PCR showed that the relative expression of CTLA-4 mRNA in the experimental group was significantly higher than that in the control group (t = 6.294, ). Conclusion: CTLA-4 plays an important role in the development of chronic tonsillitis, indicating that immunosuppressive mechanisms may exist in the process of chronic tonsillitis. Immunosuppression of tonsil lymphoid tissue provides a new explanation for the phenomenon of repeated inflammation of the tonsils in clinical practice, and at the same time provides clinical treatment of chronic tonsillitis with the possibility of developing new therapeutic drugs from the immunological point of view besides surgery.