摘要
目的 观察重症肌无力（MG）患者外周血单个核细胞（PBMC）糖皮质激素受体α同型（hGRα）含量或核转位率与激素疗效的关系。方法 收集MG患者51例、其他神经免疫性疾病（ONID）患者16例及健康对照者11名，分别提取外周血单个核细胞（PBMC）细胞核和细胞质蛋白质，采用生物素-亲和素-酶联免疫吸附试验（ABS-ELISA）定量测定经体外地塞米松（DEX）作用前、后PBMC细胞质和细胞核内hGRα含量，并计算hGRα核转位率。应用临床相对记分法评价激素疗效。结果 未经DEX处理时MG和ONID组PBMC细胞质hGRa含量均低于健康对照组（P〈0．05），经DEX处理后MG组其hGRa含量明显低于健康对照组（P〈0．01）。MG患者的性别、年龄、伴发胸腺疾病情况和hGRa含量以及hGRa核转位率间均无明显相关（P〉0．05）。Osserman分型Ⅳ型MG患者hGRa核转位率低于其他分型者（P〈0．05）。病程≥2年的MG患者hGRa核转位率明显低于病程≤6个月和病程6个月～2年的MG患者（均P〈0．01）。MG患者PBMC的细胞核内hGRa含量和hGRa核转位率与激素治疗2周（n=51，r=0．913，r=0．907，P〈0．05）和4周（n=47，r=0．929，r=0．911，P〈0．05）的临床相对评分间均呈正相关。结论 经DEX作用后PBMC细胞核内hGRa含量和激素诱导的hGRa核转位率与MG患者对激素的敏感性问呈正相关，两者可作为预测激素疗效的实验室指标。
Objective To evaluate the relations between the hGRa concentration in the nucleus or the translocation rate of hGRa from cytoplasm to the nucleus after dexamethasone （DEX） incubation and GC efficacy in MG patients. Methods PBMC from MG and controls were incubated with DEX or with PBS as contrast. PBMC total protein of cytoplasm and nucleus were extracted respectively by NE-PER extraction kits. Then a quantitative avidin biotin system enzyme-linked immunosorbent assay （ABS-ELISA） was used to measure the hGRa in cytoplasm before incubation and hGRa in nucleus after incubation of DEX to calculate the translocation rate of hGRa. Results The concentration of hGRa in the cytoplasm before DEX incubation froth MG patients and patients of other neuroimmunological disorders （ONID） was significantly lower than those in healthy controls （P〈0. 05）. The concentration of GRa in the nucleus of PBMC from MG after DEX incubation was remarkably lower than those in healthy controls （P〈0. 01）. The gender, age or the associated thymus disorders of MG had little effect on the concentration of hGRa in the cytoplasm before DEX incubation, hGRa in the nucleus after DEX incubation, or the translocation rate of hGRa（P〉0.05）. The MG patients of Osserman type Ⅳ had lower translocation rate of hGRa than MG patients of other types （P〈0.05）. The course of MG also affected the translocation rate of hGRa. In the group with the course more than 2 years, the translocation rate of hGRa was much lower than those with less than 6 months （P〈0. 001） and 6 months to 2 years （P〈 0. 01）. The concentration of hGRα in the nucleus after DEX incubation and translocation rate of hGRα were closely correlated with GC efficacy when evaluated 2 weeks （n=51, r=0. 913, r=0. 907, P=0. 05）and 4 weeks（n=47, r= 0. 929, r=0. 911, P〈0. 05） after glucocorticoids（intravenous methylprednisolone） treatment. Conclusions The concentration of hGRα in the nucleus after DEX incubation and the translocation rate of hG
出处
《中国神经免疫学和神经病学杂志》
CAS
2007年第6期320-323,335,共5页
Chinese Journal of Neuroimmunology and Neurology
