Chinese General Practice ›› 2021, Vol. 24 ›› Issue (18): 2303-2308.DOI: 10.12114/j.issn.1007-9572.2021.00.471

• Monographic Research • Previous Articles     Next Articles

Expression of Rectal Mucosal Sensory Receptors in Patients with Idiopathic Pruritus Ani 

  

  1. Department of Anorectal Surgery,the First Affiliated Hospital of Zhejiang Chinese Medical University,Hangzhou 310006,China
    *Corresponding author:XU Li,Associate chief physician;E-mail:1755889877@qq.com
  • Published:2021-06-20 Online:2021-06-20

特发性肛门瘙痒症患者直肠黏膜感觉受体表达情况研究

  

  1. 310006浙江省杭州市,浙江中医药大学附属第一医院肛肠外科
    *通信作者:徐利,副主任医师;E-mail:1755889877@qq.com
  • 基金资助:
    国家自然科学基金资助项目(81704082)——温和灸对肛门瘙痒症脂质代谢网络的调控及皮肤微生态的影响;浙江省卫计委课题(2017KY514)——肛门瘙痒症患者直肠顺应性及肠黏膜TRPV1、5-HT、P2X2受体表达的研究

Abstract: Background It is not clear for what reason causes anal moisture and leakage to stimulate the sensory nerve endings of perianal skin and form a vicious circle of pruritus and scratching so far,but research has shown that perianal moisture and leakage may be related to the abnormity of rectal sensory receptors besides perianal flora.Objective To analyze the expression of rectal mucosal sensory receptors in patients with idiopathic pruritus ani,including transient receptor potential vanilloid type 1(TRPV1),5-HT and P2RX2 polyclonal antibody.Methods Participants were recruited from the First Affiliated Hospital of Zhejiang Chinese Medical University during January 2017 to June 2019,including 30 outpatients and inpatients with idiopathic pruritus ani(pruritus group)from Departments of Anorectal Surgery and Gastroenterology,and 29 physical examinees(healthy group).Immunohistochemical method and real-time fluorescence quantitative polymerase chain reaction(PCR)were used to detect the expression of TRPV1,5-HT and P2RX2 polyclonal antibody in rectal mucosal tissue.Results Immunohistochemical results showed that,TRPV1 and 5-HT were positively expressed but P2RX2 polyclonal antibody was negatively expressed in rectal mucosal tissue of pruritus group.MOD value and HIS score of TRPV1 and 5-HT in pruritus group were significantly higher than those in healthy group(P<0.01).But there was no significant difference of MOD value or HIS score of P2RX2 polyclonal antibody between the two groups(P>0.05).Real-time fluorescence quantitative PCR results showed that,the pruritus group had significantly higher relative expression quantity of mRNA of TRPV1 and 5-HT than healthy group(P<0.01),but there was no significant intergroup difference of relative expression quantity of mRNA of P2RX2 polyclonal antibody between the two groups(P>0.05).Conclusion The expression of rectal mucosal sensory receptors including TRPV1 and 5-HT significantly increase in patients with idiopathic pruritus ani,and the over-expression of TRPV1 and 5-HT may be related to reduced rectal compliance and increased rectal sensory threshold,which may be due to sensitization or phenotypic alteration of transmitters in rectal mucosal sensory transmission.

Key words: Pruritus ani, Rectum, Intestinal mucosa, Sensation, TRPV cation channels, 5- hydroxytryptamine receptors, P2RX2 polyclonal antibody

摘要: 背景 对于特发性肛门瘙痒症,何种原因导致肛门潮湿、渗漏并刺激肛周皮肤感觉神经末梢而形成瘙痒-搔抓的恶性循环,目前仍不清楚。有研究表明,肛周皮肤潮湿、渗漏除受肛周菌群影响外,还可能与直肠感觉受体异常相关。目的 分析特发性肛门瘙痒症患者直肠黏膜感觉受体瞬时感受器电位香草酸受体1(TRPV1)、5-羟色胺(5-HT)、三磷酸腺苷受体受体P2X2抗体表达情况。方法 选取2017年1月—2019年6月浙江中医药大学附属第一医院肛肠外科与消化内科收治的门诊及住院特发性肛门瘙痒症患者30例作为瘙痒组,同期在浙江中医药大学附属第一医院体检健康者29例作为健康组。采用免疫组化、实时荧光定量聚合酶链式反应(PCR)检测两组受试者直肠黏膜组织TRPV1、5-HT、三磷酸腺苷受体受体P2X2抗体表达情况。结果 免疫组化结果显示,瘙痒组患者直肠黏膜组织TRPV1、5-HT呈阳性表达,三磷酸腺苷受体受体P2X2抗体呈阴性表达,且瘙痒组患者TRPV1平均光密度(MOD)值及HIS评分、5-HT MOD值及HIS评分高于健康组(P<0.01),而两组受试者直肠黏膜组织三磷酸腺苷受体受体P2X2抗体MOD值及HIS评分比较,差异无统计学意义(P>0.05)。实时荧光定量PCR结果显示,瘙痒组患者直肠黏膜组织TRPV1、5-HT mRNA相对表达量高于健康组(P<0.01),而两组受试者直肠黏膜组织三磷酸腺苷受体受体P2X2抗体mRNA相对表达量比较,差异无统计学意义(P>0.05)。结论 特发性肛门瘙痒症患者直肠黏膜感觉受体TRPV1、5-HT的表达明显升高,其直肠顺应性降低、感觉阈值升高可能与TRPV1、5-HT的过表达有关,并可能是由于直肠黏膜感觉传递中递质敏化或表型改变所致。

关键词: 肛门瘙痒症, 直肠, 肠黏膜, 感觉, TRPV阳离子通道, 5-羟色胺受体, 三磷酸腺苷受体受体P2X2抗体