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目的:观察雌激素受体在夹层主动脉中的表达情况,探讨其在主动脉夹层发病过程中的作用及可能机制。方法:维多利亚蓝染色,免疫组织化学染色分别观察正常与夹层主动脉的组织病理学改变及雌激素受体的表达,Western blot分析正常与夹层主动脉中雌激素受体、结缔组织生长因子(CTGF)、基质金属蛋白酶2(MMP-2)和基质金属蛋白酶9(MMP-9)的蛋白表达,分析雌激素受体表达与CTGF、MMP-2、MMP-9表达的关系。结果:夹层主动脉中弹力纤维断裂,胶原沉积增多,两者排列疏松、紊乱,比例失调,正常主动脉未见异常。雌激素受体在正常与夹层主动脉均有表达,但夹层主动脉中雌激素受体β蛋白表达降低(P<0.01),而CTGF、MMP-2与MMP-9蛋白表达升高(P<0.05)。雌激素受体β与CTGF、MMP-2、MMP-9表达显著相关(P<0.05),CTGF与MMP-9表达显著相关(P<0.05)。结论:主动脉壁中雌激素受体β下调可能通过CTGF表达升高及促进MMP-9分泌,引起细胞外基质重构,增加主动脉夹层的易感性。
OBJECTIVE: To observe the expression of estrogen receptor in the dissected aorta and to explore its possible role in the pathogenesis of aortic dissection. Methods: The histopathological changes of normal and dissected aorta and the expression of estrogen receptor were observed by Victoria blue staining and immunohistochemical staining. The expressions of estrogen receptor, connective tissue growth factor (CTGF) ), MMP-2 and MMP-9, and to analyze the relationship between estrogen receptor expression and the expression of CTGF, MMP-2 and MMP-9. Results: The elastic fibers in the dissected aorta ruptured and the collagen deposition increased. The two arranged loosely and disorderly with the imbalance of the normal aorta. The expression of estrogen receptor in normal and dissected aorta was lower than that in normal group (P <0.01), while the expressions of CTGF, MMP-2 and MMP-9 were increased (P < 0.05). The expression of estrogen receptor β was significantly correlated with the expression of CTGF, MMP-2 and MMP-9 (P <0.05), while the expression of CTGF was significantly correlated with the expression of MMP-9 (P <0.05). CONCLUSION: The down-regulation of estrogen receptor β in the aortic wall may be caused by the increase of CTGF expression and secretion of MMP-9, resulting in extracellular matrix remodeling and increased susceptibility to aortic dissection.