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目的观察骨桥蛋白(osteopontin,OPN)在退行性变升主动脉瘤(Degenerative ATAA,DATAA)中的表达,初步探讨OPN及平滑肌细胞表型转化在DATAA发病中的作用。方法升主动脉瘤术中切除标本18例为DATAA组,冠状动脉搭桥患者术中主动脉标本18例为对照组。应用实时定量PCR的方法检测所有标本中OPN的mRNA表达水平,免疫组化方法检测主动脉壁中OPN的表达情况,H-E染色和Masson染色分别检测主动脉壁的一般情况及胶原的含量。结果 DATAA组OPN的免疫组化半定量结果与对照组相比表达增加(P<0.01),与主动脉直径显著相关(r=0.737,P<0.01),主要位于中膜及外膜;实时PCR结果与免疫组化结果一致(P<0.01)。胶原纤维在DATAA中表达增加(P<0.01),与OPN表达量正相关(r=0.694,P<0.01)。组织学结果显示DATAA组标本弹力蛋白降解明显,平滑肌细胞增生及排列紊乱。结论 OPN在DATAA主动脉壁中高表达,胶原含量在DATAA中表达增强。合成型平滑肌细胞增多可能导致了胶原分泌增加,参与了升主动脉瘤壁的重塑过程,在DATAA的发病中具有重要的作用。
Objective To investigate the expression of osteopontin (OPN) in degenerative aortic aneurysm (DATAA), and to explore the role of OPN and phenotype of smooth muscle cells in the pathogenesis of DATAA. Methods 18 cases of ascending aortic aneurysm resection specimens for DATAA group, coronary artery bypass graft in patients with aortic specimens of 18 cases as the control group. The mRNA expression of OPN in all the specimens was detected by real-time PCR. The expression of OPN in the aorta wall was detected by immunohistochemistry. The aortic wall and collagen content were detected by H-E staining and Masson staining respectively. Results The immunohistochemical semiquantitative results of OPN in DATAA group were significantly higher than those in control group (P <0.01), but significantly correlated with the diameter of aorta (r = 0.737, P <0.01) The results were consistent with the results of immunohistochemistry (P <0.01). Collagen fibers increased in DATAA (P <0.01), and positively correlated with OPN expression (r = 0.694, P <0.01). Histological results showed that DATAA group of specimens elastin degradation significantly, smooth muscle cell proliferation and arrangement disorders. Conclusion OPN is highly expressed in the aortic wall of DATAA and the expression of collagen is increased in DATAA. Increased synthesis of smooth muscle cells may lead to increased collagen secretion, involved in ascending aortic aneurysm wall remodeling process, in the incidence of DATAA plays an important role.