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[克罗恩病和溃疡性结肠炎患儿结肠黏膜巨噬细胞的免疫组织化学研究]

[Immunohistochemical study of colonic mucosa macrophages in children with Crohn's disease and ulcerative colitis].

作者信息

Rodrigues M, Zerbini M C, Barbieri D

机构信息

Departamento de Gastroenterologia, Hospital das Clínicas de Faculdade de Medicina da Universidade de São Paulo, HC-FMUSP.

出版信息

Arq Gastroenterol. 1998 Oct-Dec;35(4):283-91.

Abstract

In this research the histological characteristics of the macrophages on the colonic mucosa in Crohn's disease and ulcerative colitis were quantified and analysed. Twelve Crohn's disease, 19 ulcerative colitis and 10 specimen of the rectal mucosa, representing the control group according to the followed model, were studied: I period (PI) = pre-treatment, II period (PII) = up two years of evolution and III period (PIII) = more than two years of evolution. The macrophages were identified in a colonic mucosa by the monoclonal CD68 through the immunoperoxidase method. The macrophages quantification was done by chromatic computer images analysis, that express the area (mm2) used by the CD68 positive cells, in percentage. The percentage of the area used by the macrophages was increased in both diseases, in all the studied periods, when compared with the control group, but without statistic significance. The macrophages' distribution inside the control group mucosa was subepithelial, while in the illness group, it reached all the mucosa that was concentrated on the basis of ulcers and all long the fissures. On the Crohn's disease the CD68 positive cells facilited the identification of the microgranulomas, sometimes unnoticed in the hematoxiline-eosine. Although there was no difference between patients and control group in the macrophages area, the difference in the distribution could suggest the macrophages' participation on the injure in both diseases although they do not permit a differential diagnosis because of the variety of the values. The CD68 did not identify the different functional status of the macrophages, but their position in the mucosa suggest that, in terms of fissures and ulcers, their mainly function should be the phagocitosis and in the other cases, they have been the cells that should show the antigens and that recruit the other inflammatory cells.

摘要

在本研究中,对克罗恩病和溃疡性结肠炎患者结肠黏膜中的巨噬细胞组织学特征进行了定量分析。按照如下模型,研究了12例克罗恩病患者、19例溃疡性结肠炎患者以及10例直肠黏膜标本(作为对照组):I期(PI)=治疗前,II期(PII)=病程两年以内,III期(PIII)=病程超过两年。通过免疫过氧化物酶法,利用单克隆CD68在结肠黏膜中识别巨噬细胞。巨噬细胞定量采用计算机彩色图像分析,以CD68阳性细胞所占面积(mm²)的百分比表示。与对照组相比,两种疾病在所有研究阶段巨噬细胞所占面积百分比均增加,但无统计学意义。对照组黏膜内巨噬细胞分布于上皮下,而疾病组中,巨噬细胞遍布整个黏膜,且在溃疡底部和裂隙处聚集。在克罗恩病中,CD68阳性细胞有助于识别微小肉芽肿,苏木精-伊红染色有时难以发现这些微小肉芽肿。尽管患者与对照组在巨噬细胞面积上无差异,但分布差异可能提示巨噬细胞参与了两种疾病的损伤过程,不过由于数值的多样性,无法进行鉴别诊断。CD68无法识别巨噬细胞的不同功能状态,但其在黏膜中的位置表明,就裂隙和溃疡而言,其主要功能应为吞噬作用,而在其他情况下,它们是呈递抗原并募集其他炎症细胞的细胞。

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