肠道粘膜屏障功能及其临床检测

肠道粘膜屏障功能及其临床检测:2004-07-01:(1975-),,,,;(1939-),,,,;(1961-),,,,尉秀清1,2综述姚集鲁2,文卓夫1审校(中山大学附属第三医院11消化内科;21传染科,广东广州510630):,;,;:;;:R446:A:1004-2369(2004)10-0415-04,,,:1111机械屏障,,,(Panethcell),:¹,,,;º,[1],,,(Antibioticpeptide)5(humandefensin5,HD-5)6-(humandefensin-6,HD-6),32~36,,,[2],,,,;,[3];,[4],,,,,#415#2004103110,,,,112化学屏障,;,;;,,,113生物屏障99%,,[5](),,(),;,pH,114免疫屏障,(gu-tassociatedlymphoidtissue,GALT),Peyer(Peyer.spatches),;11411M:,[6],,,;,,,,MTB,B,,,,IgA,M,,M/0(firstinformationconduct)[7]11412(LPL):LPL,TB,Th2,CD4+Th2Th2(TGF)-B(IL)-4IL-5IL-6IL-10,IgA,,,[8]11413(intraepitheliallym-phocytes,IEL):,CD8+,,,IL-2,3,4,5,10(IFN)-AIFN-C,TGF-B;IELT(NK),,IEL,[9],[10]11414:(M),M,,;,,MM,M,,,#416#200410311011415IgA(secretoryimmunoglobulinA,sIgA):,,,sIgA,[11]sIgA,,,FC,sIgAIgA+,IgA+,11416:,,2211反映肠道粘膜机械屏障的指标21111:,,,,,(DTPAEDTA),;(PEG)PEG;,/,,[1]21112:HE,,1mm,21113:,,;/[12],212反映肠道粘膜生物屏障的指标,,213反映肠道粘膜免疫屏障的指标sIgA21311sIgA:IgA+,IgA+IgA+,sIgA[13,14];sIgA[15]21312IEL:HE500~1000,,IEL,21313:CD68,CD68,,,10CD68+,[16,17]#417#2004103110214反映肠道屏障功能完整性的综合指标,,,21411:,,,,,21412:,,,,PUC19[18],,,PUC19,,,;,,21413(PCR):,50%[19],50%~90%,Kane[20]PCR;,Kane[21]BG-1/BG-4BFR-1/BFR-116SrRNA-/16SrRNA-DNA,,PCR,3,;,:[1]BjarnasonI,MacPhersonA,HollanderD1[J]1Gas-troenterology,1995,108:1566-15811[2]CunliffeRN1[J]1MolImmunol,2003,40:463-4671[3]MantisNJ,CheungMC,ChintalcharuvuKR,etal1[J]1JImmunol,2002,169:1844-18511[4]SpecianRD,OliverMG1[J]1AmJPhysiol,1991,26(2,Ptl):183-1931[5]FooksLJ,GibsonGR1[J]1BrJNutr,2002,88:39-49S1[6]KucharzikT,LugeringA,LugeringN,etal1[J]1AlimentPharmacolTher,2000,14:247-2561[7]GebertA,GokeM,RothkotterHJ,etal1[J]1ZGastroenterol,2000,38:855-8721[8]SchaferF,KewenigS,StolteN,etal1[J]1Gut,2002,50:608-6141[9]BoismenuR1[J]1ImmunolRes,2000,21:123-1271[10]HavranWL1[J]1ImmunolRes,2000,21:63-691[11]MacphersonAJ,HunzikerL,McCoyK,etal1[J]1MicrobesInfect,2001,3:1021-10351[12]SuchJ,GurardiolaJV,deJuanJ,etal1[J]1EurJGastroenterolHepatol,2002,14:371-3761[13]NilssenDE,OktedalenO,LygrenI,etal1[J]1IntJSportsMed,1998,19:425-4311[14],,,1[J]1,2003,41(5):385-3881[15]NagoAT,PilogalloM,PereiraAB,etal1[J]1AdvExpModBiol,1995,371A:507-5111[16]LepidiH,FenollarF,GerolamiR,etal1[J]1HumPathol,2003,34:589-5961[17]RodriguesM,ZerbiniMC,BarbieriD1[J]1ArqGas-troenterol,1998,35:283-2911[18]KazantsevGB,HechtDW,RaoR,etal1[J]1AmJSurg,1994,167:201-2061[19]O.BoyleCJ1[J]1Gut,1998,43:29-351[20]KaneTD,JohnsonSR,AlexanderJW,etal1[J]1JSurgRes,1996,63:59-631[21]KaneTD,AlexanderJW,JohannigmanJA1[J]1AnnSurg,1998,227:1-91(编辑:林影)#418#2004103110