摘要
目的分析食管癌全胸段切除后切口感染外周血单核细胞Kelch样环氧氯丙烷相关蛋白1(Keap1)-核转录因子E2相关因子(Nrf2)信号通路的变化及意义。方法选择2018年5月-2021年2月青海省人民医院收治的行全胸段切除术的食管癌患者96例,根据术后是否发生切口感染分为切口感染组34例和无切口感染组62例,采集感染患者标本进行病原菌分离、鉴定,检测两组患者外周血单核细胞Keap1-Nrf2信号通路相关基因表达及下游抗氧化酶、血清氧化应激指标水平、T淋巴细胞亚群水平变化。结果34例感染患者共分离病原菌46株,以革兰阴性菌为主(67.39%);切口感染组患者外周血单核细胞keapl mRNA表达量高于无切口感染组患者(P<0.05),Nrf2、抗氧化反应元件(ARE)以及血红素加氧酶(HO-1)、醌氧化还原酶(NQO-1)mRNA表达量低于无切口感染组患者(P<0.05);切口感染组患者血清丙二醛(MDA)、髓过氧化物酶(MPO)水平高于无切口感染组患者(P<0.05),超氧化物歧化酶(SOD)、过氧化氢酶(CAT)、谷胱甘肽过氧化物酶(GSH-Px)水平低于无切口感染组患者(P<0.05);切口感染组患者外周血T淋巴细胞亚群CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)水平低于无切口感染组患者(P<0.05)。结论食管癌全胸段切除后切口感染与外周血单核细胞Keap1-Nrf2信号通路表达抑制存在密切关联,可能与增加氧化应激及抑制免疫反应有关,明确术后感染原因及发病机制对改善患者预后至关重要。
OBJECTIVE To analyze the changes and significance of Kelch-like ECH-associated protein 1(Keap1)-nuclear factor E2 related factor(Nrf2)signaling pathway in peripheral blood mononuclear cells in patients with incision infection after total thoracic esophagectomy of esophageal carcinoma.METHODS A total of 96 patients with esophageal carcinoma undergoing total thoracic esophagectomy in Qinghai Provincial People’s Hospital from May 2018 to Feb 2021 were selected and divided into an incision infection group of 34 cases and a non-incision infection group of 62 cases according to whether incision infection occurred after surgery.The specimens were collected from infected patients for isolation and identification of pathogenic bacteria,and the expressions of Keap1-Nrf2 signaling pathway-related genes in peripheral blood mononuclear cells,downstream antioxidant enzymes,serum oxidative stress indicators and T lymphocyte subsets levels were detected in the two groups of patients.RESULTS A total of 46 strains of pathogenic bacteria were isolated from 34 infected patients,mainly Gram-negative bacteria(67.39%).The expression of Keap1 mRNA in peripheral blood mononuclear cells in incision infection group was higher than that in non-incision infection group(P<0.05),while the expressions of Nrf2 mRNA,ARE mRNA,HO-1 mRNA and NQO-1 mRNA were significantly lower than those in non-incision infection group(P<0.05).The levels of serum MDA and MPO of patients in incision infection group were significantly higher than those in non-incision infection group(P<0.05),while the levels of SOD,CAT,and GSH-Px were significantly lower than those in non-incision infection group(P<0.05).The levels of peripheral blood T lymphocyte subsets CD_(3)^(+),CD_(4)^(+) and CD_(4)^(+)/CD_(8)^(+) were significantly lower in incision infection group than those in non-incision infection group(P<0.05).CONCLUSION Incision infection after total thoracic esophagectomy of esophageal carcinoma was closely related to the inhibition of Keap1-Nrf2 signal pathway expressi
作者
鄂德琇
冶治
田生秀
郭亚楠
王鹰
E De-xiu;YE Zhi;TIAN Sheng-xiu;GUO Ya-nan;WANG Ying(Qinghai Provincial People'sHospital,Xining,Qinghai 810007,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2022年第11期1707-1711,共5页
Chinese Journal of Nosocomiology
基金
青海省自然科学基金资助项目(2020419)。
