Diferencijacija genske ekspresije kod bolesnika sa analnom fistulom ukazuje na visoki nivo prolaktinskih receptora

  • Yi-huan Song Department of Colorectal Surgery, The Third Hospital of Hangzhou, Hangzhou, Zhejiang Province, China; Department of General Surgery, The First Hospital of Jiaxing, China
  • Jian-ming Qiu Department of Colorectal Surgery, The Third Hospital of Hangzhou, Hangzhou, Zhejiang Province, China.
  • Guan-gen Yang Department of Colorectal Surgery, The Third Hospital of Hangzhou, Hangzhou, Zhejiang Province, China.
  • Dong Wang Department of Colorectal Surgery, The Third Hospital of Hangzhou, Hangzhou, Zhejiang Province, China.
  • A-li Lin Department of Pathology,The Third Hospital of Hangzhou, Hangzhou, Zhejiang Province, China
  • Kan Xu Department of Colorectal Surgery, The Third Hospital of Hangzhou, Hangzhou, Zhejiang Province, China.
DOI: https://doi.org/10.2298/VSP160210262S
Ključne reči: rectal fistula||, ||rektum, fistula, receptors, prolactin||, ||receptori, prolaktinski, gene expression||, ||geni, ekspresija, immunohistochemistry||, ||imunohistohemija, biological markers||, ||biološki pokazatelji,

Sažetak


Uvod/Cilj. Ispitivanja varijacija u lokalnoj ekspresiji medijatora inflamacije kod analnih fistula su ograničena, a očekuje se da bolje razumevanje ove oblasti može da doprinese razvoju potencijalnih terapijskih opcija poput uvođenja instilacione terapije kod komplikovanih slučajeva. Cilj ove studije bio je da se ispitaju prolaktinski receptori (PRLR) kao pokazatelji inflamacije i utvrdi korelacija njihove ekspresije sa kompleksnošću analnih fistula i verovatnoćom pojave recidiva. Metode. Pomoću metode microarray najpre je izvršena diferencijacija gena u uzorcima analne mukoze bolesnika sa hemoroidima (kontrolna grupa), a potom prospektivno i kod bolesnika sa analnim fistulama (n = 65). Obe grupe bolesnika bile su komparabilne u pogledu starosti i pola. Imunohistohemijska analiza PRLR učinjena je sa ciljem definisanja njihove genske ekspresije kod nekomplikovanih, kompleksnih i recidivantnih analnih fistula. Kvantitativno poređenje bojenih preparata postignuto je kombinovanjem intenziteta bojenja sa ćelijskom distribucijom čime je dobijen nizak i visok skor PRLR. Rezultati. Diferencijalni profil ekspresije nađen je za 190 gena . Ekspresija PRLR bila je 2,91 puta manja kod analnih fistula u poređenju sa uzorcima kontrolne grupe. U grupi sa analnim fistulama, od 65 bolesnika bilo je 35 sa nekomplikovanim i 30 sa kompleksnim fistulama. Kod nekomplikovanih fistula ekspresija PRLR bila je značajno viša nego kod kompleksnih slučajeva sa recidivantnim fistulama, a ukupno niža u odnosu na de novo fistule (p = 0,001). Ovi nalazi reflektovali su se u izmerenim vrednostima integrisane optičke gustine za kompleksne i rekurentne fistule (kompleksne fistule, 8,31 ± 4,91 ´ 104 vs nekomplikovane fistule, 12,30 ± 6,91 ´ 104 ; p < 0,05); recidivantne fistule, 7,21 ± 3,51 ´ 104 vs primarno izlečene fistule, 8,31 ± 4,91 ´ 104; p < 0,05). Univarijatna regresiona analiza pokazala je da je niska ekspresija PRLR bila u korelaciji sa kompleksnošću fistule, a ovo je se pokazalo i kao značajan nezavisan faktor u multivarijantnoj [odds ratio (OR) za nisku prema visokoj ekspresiji PRLR = 9,52; p = 0,001].
Zaključak. Ekspresija PRLR stoji u inverznoj korelaciji sa kompleksnošću analnih fistula. Dalja istraživanja trebalo bi da definišu specifičnost ovog nalaza i njegovu povezanost sa drugim konvencionalnim medijatorima inflamacije.

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Objavljeno
2017/07/05
Broj časopisa
Vol. 74 Br. 5 (2017)
Rubrika
Originalni članak