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目的分析慢性鼻-鼻窦炎鼻息肉组织中金黄色葡萄球菌(简称金葡菌)超抗原与T细胞受体Vβ区(T-cellreceptorVbetaregion,TCRVβ)的基因表达的关系,探讨金葡菌超抗原在鼻息肉发生中的可能作用。方法对22例Ⅱ型1~3期双侧鼻息肉患者、15例Ⅰ型1~3期慢性鼻-鼻窦炎患者和12例正常对照组的鼻息肉或黏膜组织,采用酶联免疫吸附实验(enzyme-linkedimmunosorbentassay,ELISA)方法检测金葡菌肠毒素,并应用逆转录-聚合酶链反应(reversetranscriptase-polymerasechainreaction,RT-PCR)技术分析鼻黏膜中TCRVβ基因的表达情况。结果鼻息肉患者金葡菌肠毒素阳性率为54·54%(12/22),鼻窦炎组和正常对照组无阳性结果。超抗原金葡菌肠毒素B(StaphylococcalexotoxinB,SEB)阳性的息肉组织中,Vβ3(表达强度,下同,10·02)、Vβ14(3·54)、Vβ15(2·39)、Vβ17(3·48)、Vβ20(2·94)表达强度均较鼻窦炎组和正常鼻黏膜组织显著增高(P值均<0·05)。中毒性休克综合征毒素-1(toxicshocksyndrometoxin-1,TSST-1)阳性者Vβ2(13·8)、Vβ6·1-3(6·53)优势表达(P值均<0·05)。超抗原阴性鼻息肉组织无集中优势基因表达;鼻窦炎组较正常组鼻黏膜TCRVβ亚家族表达有增高趋势(P值均>0·05),但无优势表达片段。结论金葡菌超抗原与慢性鼻-鼻窦炎鼻息肉TCRVβ谱的偏移密切相关,可能在鼻息肉的发病机制中有一定作用。
Objective To analyze the relationship between the expression of T-cell receptor Vβ (TCRVβ) and the gene of Staphylococcus aureus (TCRVβ) in chronic nasosinusitis and nasal polyps, Possible role in nasal polyps. Methods Nasopharyngeal mucosa and mucosa tissues of 22 patients with type Ⅱ 1-3 stage bilateral nasal polyps, 15 type Ⅰ 1-3 stage patients with chronic rhinosinusitis and 12 normal controls were enrolled in this study. Enzyme-linked immunosorbent assay (ELISA) enzyme-linked immunosorbentassay (ELISA) was used to detect Staphylococcus aureus enterotoxin. The expression of TCRVβ gene in nasal mucosa was analyzed by reverse transcriptase-polymerase chain reaction (RT-PCR). Results The positive rate of Staphylococcus aureus enterotoxin in nasal polyps was 54.54% (12/22). There was no positive result in sinusitis group and normal control group. Vβ3 (expression intensity, the same below, 10.02), Vβ14 (3.54), Vβ15 (2.39), Vβ17 (3 · 5) were significantly higher in the polyp tissue than in the superantigen Staphylococcus xotoxin B (SEB) 48), Vβ20 (2.94) were significantly higher than those in sinusitis group and normal nasal mucosa (all P <0.05). Vβ2 (13 · 8) and Vβ6 · 1-3 (6 · 53) positive for toxicshocksyndrometoxin-1 (TSST-1) were predominantly expressed (all P <0.05). The expression of TCRVβ subfamily of nasal mucosa in sinusitis group was higher than that in normal nasal mucosa (all P> 0.05), but there was no dominant expression fragment. Conclusion Staphylococcus aureus superantigen is closely related to the shift of TCRVβ spectrum in chronic rhinosinusitis and nasal polyps and may play a role in the pathogenesis of nasal polyps.