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目的探讨凋亡相关蛋白细胞色素C(CytC)、caspase-9、caspase-3在颞叶内侧癫癎(MTLE)病人致癎海马CA1区神经元内的表达及意义。方法选择30例典型MTLE病人为实验组,6例颞叶深部血管畸形病人为对照组。采用苏木精-伊红染色、原位末端标记(TUNEL)方法在光镜下观察MTLE病人致癎海马CA1区神经元凋亡的情况。采用免疫组化S-P法检测并比较MTLE海马CA1区与对照组海马组织神经元内凋亡相关蛋白CytC、caspase-9、caspase-3的表达。结合病史资料,分析caspase-3表达水平与癫癎病程和发作频率的相关性。结果MTLE组致癎海马CA1区光镜下可观察到神经元退变、噬神经元现象,TUNEL染色发现凋亡神经元18例,对照组则为阴性;CytC、caspase-9、caspase-3蛋白在MTLE组海马CA1区均有明显表达,对照组中则呈轻微表达,差异显著(P<0.01)。caspase-3蛋白表达水平与发作频率呈正相关,而与病程长短无关。结论MTLE致癎海马神经元中存在外源性凋亡途径,这可能是癫癎发展的重要因素之一。
Objective To investigate the expression and significance of apoptosis-related cytochrome C (CytC), caspase-9 and caspase-3 in neurons of hippocampal CA1 area of temporal lobe medial epilepsy (MTLE). Methods Thirty patients with typical MTLE were selected as experimental group and six patients with temporal lobe deep vascular malformation as control group. The apoptosis of hippocampal CA1 neurons in the hippocampus of MTLE patients was observed under light microscope by hematoxylin-eosin staining and TUNEL method. The expression of CytC, caspase-9 and caspase-3 in the hippocampal neurons of MT1 hippocampus CA1 area and control group were detected by immunohistochemical S-P method. According to the history data, the correlation between the expression level of caspase-3 and the course of epilepsy and the frequency of seizure was analyzed. Results The neuron degeneration was observed in the hippocampal CA1 region of the hippocampus in MTLE group. Eutopic neurons were detected by TUNEL staining in 18 cases of apoptotic neurons and negative in the control group. CytC, caspase-9 and caspase-3 proteins In the MTLE group, the hippocampal CA1 region was significantly expressed in the control group was slightly expressed, the difference was significant (P <0.01). The expression of caspase-3 protein was positively correlated with the seizure frequency, but not with the duration of the disease. Conclusion There are extrinsic apoptotic pathways in the hippocampal neurons of MTLE-induced leprosy, which may be one of the important factors in the development of epilepsy.