外周血单个核的细胞中糖皮质激素受体亚型与突发性聋预后的相关性

Preliminary Study of the Relationship of GR Isoforms Level of Peripheral Blood Mononuclear Cells(PBMCs) and Prognosis in SSNHL Patients

戴艳红;陆玲;吴骎;袁文杰;张秀玲;佘万东;

1:南京大学医学院附属鼓楼医院耳鼻咽喉科

2:南京大学医学院

3:江阴市人民医院

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摘要

目的探讨外周血单个核的细胞(peripheral blood mononuclear cells,PBMCs)中糖皮质激素受体(glucocorticoid receptor,GR)亚型与突发性聋(sudden sensorineural hearing loss,SSNHL)预后的相关性以及糖皮质激素(glucocorticoid,GC)治疗对GR亚型表达的影响。方法选择27例应用GC治疗的SSNHL患者,根据听力预后分为有效组(PTA改善≥15dB)15例和无效组(PTA改善<15dB)12例,6例听力正常的鼻中隔偏曲志愿者为对照组。采用实时荧光定量PCR(quantitative real time PCR,QRT-PCR)检测各组对象外周血单个核细胞中的GRαmRNA、GRβmRNA和SRp30cmRNA的表达水平,并随访3个月以上。分析GRαmRNA、GRβmR-NA、SRp30cmRNA表达量和GRαmRNA/GRβmRNA比值在有效组、无效组和对照组间的差异以及SSNHL患者GC治疗前后的差异。结果 27例SSNHL患者中采用鼓室灌注GC治疗20例,静脉滴注GC治疗7例,治疗后有效15例,无效12例。有效组、无效组和对照组间PBMCs中GRαmRNA、GRβmRNA、SRp30cmRNA表达量和GRαmRNA/GRβmRNA比值比较差异无统计学意义。鼓室灌注GC治疗前后均留取血标本15例,其中有效8例,无效7例,有效组GC灌注后PBMCs中GRαmRNA和GRβmRNA表达量均较灌注前下降(ZGRα=-2.380,PGRα=0.017;ZGRβ=-2.521,PGRβ=0.012),而无效组GC灌注前后两者的表达差异无统计学意义(P>0.05)。结论本组SSNHL患者治疗前PBMCs中GRαmRNA、GRβmRNA、SRp30cmRNA表达量和GRαmRNA/GRβmRNA比值均与SSNHL的听力预后无相关性,尚不能用来预测SSNHL患者对GC的敏感性和听力预后;但鼓室灌注GC治疗后GRαmRNA和GRβmRNA表达量下调可能提示有较好的听力预后。

关键词

糖皮质激素;敏感性;糖皮质激素受体亚型;突发性聋;外周血单个核细胞

基金项目(Foundation):

南京市医学科技发展项目(WKK09105);; 2009年江苏省“六大人才高峰项目”;; 江苏省大学生创新计划项目(XZ1110284098);; 南京市科委国际联合研究项目(2012sd311038)

作者

戴艳红;陆玲;吴骎;袁文杰;张秀玲;佘万东;

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糖皮质激素敏感性糖皮质激素受体亚型突发性聋外周血单个核细胞

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戴艳红陆玲吴骎袁文杰张秀玲佘万东