【摘要】 目的探讨il1的基因多态性影响h.pylori感染后胃癌发生的机制。方法通过多态性分析和血清h.pylori抗体测定,收集105例癌低发区的学生作为研究对象,其中il1511t/t基因型32名(13名h.pylori+),c/c基因型36名(15名h.pylori+),c/t基因型37名(14名h.pylori+)。结果在胃体组织,h.pylori阴性个体tnfα和nfκb表达量极少,而且il1b511各基因型间也无显著差异。在h.pylori阳性个体,胃体部tnfα和nfκb mrna有较为明显的表达,il1b511t/t基因型个体比c/t和c/c基因型明显增加,分别为1.20±0.17 vs. 0.87±0.18和0.94±0.16;1.10±0.16 vs 0.90±0.15和0.97±0.17,f=33.4和12.9,p=0.0001和0.001。h.pylori阴性的nfκb mrna活性很低。在h.pylori阳性个体,nfκb 活性显著增加。而且il1b511t/t基因型个体比c/t和c/c基因型明显增加,分别为0.99±0.12vs 0.89±0.15和0.90±0.14,f=5.6,p=0.005。结论h.pylori感染促进tnfα和nfκb mrna表达,上调nfκb活性,在il1b511t/t基因型个体更明显。提示h.pylori感染后,存在il1b基因多态性→il1β↑→炎症细胞因子↑→胃癌发生的完整通路。WwW.133229.cOM
【关键词】 胃癌;il1b;多态性;tnfα;nfκb;炎症
enhenced nfκb activity and tnfα transcript in h.pylori (+) individuals are associated with il1b gene polymorphisms
cheng huanchao1, feng jueping2, wei shaozhong1, zhang keliang1, li guangcan1, hu desheng1, hu yanping1, hu sheng1
1.the department of oncology,hubei cancer hospital,wuhan 430079, china;2.the fourth hospital of wuhan city
corresponding author: hu sheng,email: ehusmn@yahoo.com.cnabstract:objective il1β gene polymorphisms affect the expression of of il1β. the induction of il1β by h.pylori strongly inhibited acid secretion,which has been supposed to contribute to a high incidence of gastric cancer. however, il1b511 t allele has no influence in gastric acid output according to our recent study. we hypothesized that the expression of proinflammatory cytokine such as il1b and tnfa and activation of nfκb may be involved in il1b511 t allele associated gastric cancerogenesis.methodsone hundred and five healthy samples from the regions with low incidence of gastric cancer were genotyped for il1beta 511 polymorphisms by pcrrflp. the expression of il1β, nfκb and tnfα were measured using rtpcr, and nfκb activity were detected by emsa.resultsin gastric corpus of h.pylori() individuals, the expression of nfκb and tnfα were similar and remarkably lower than h.pylori(+) group.in addition, t/t genotype of il1b511 among the h.pylori infected individuals, expressed higher level of nfκb and tnfα(1.20±0.17 vs. 0.87±0.18 and 0.94±0.16;1.10±0.16 vs. 0.90±0.15 and 0.97±0.17,f=33.4 and 12.9,p=0.0001 and 0.001,respectively) and induced the strongest nfκb activity (0.99±0.12 vs. 0.89±0.15 and 0.90±0.14,f=5.6,p=0.005) than that of other two genotypes. whereas,h.pylor() individuals showed attenuated activity of nfkb.conclusionchronic h.pylori infection induced expression of il1β, tnfα and activate nfκb activity, which predisposed individuals with il1b511t/t genotype. our findings suggested tnfα and nfκb signaling play crucial role in the relationship between il1b gene polymorphism and gastric cancerogenesis.
key words:gastric cancer; il1b; polymorphism; tnfα; nfκb;inflammatory
1资料与方法
1.1研究对象通过多态性分析和血清抗体测定,收集胃癌低发区(广东籍贯)的105例健康学生作为研究对象,无胃病史、无系统性红斑狼疮、糖尿病、类风湿性关节炎、炎症性肠病病史、无胃癌家族史。其中il1511t/t基因型32名(13名h.pylori+),c/c基因型36名(15名h.pylori+),c/t基因型37名(14名h.pylori+)。具体资料见表1。表1所有研究对象的一般资料
tab 1common materials of 105 subjectsil1511基因型(il1511genotype)t/t(n=32)c/t(n=36)c/c(n=37)h.pylori+ 13 15 141sex(f/m) 14/18 16/20 18/192age(years) 22.6±1.6 22.7±1.5 22.0±1.63 1:χ2=0.7;2:χ2=0.3,p>0.05;3:f=0.2,p>0.05il1b511基因多态型分析(使用avai核酸内切酶,识别序列为c▲(t/c)cg(a/g)g)和h.pylori抗体测定(elisa方法,试剂盒为biocheck 公司产品,igg>20u/ml为阳性),具体见文献[5]。在各基因型之间,h.pylori感染率、性别构成和年龄均无明显差异,提示各基因型间的一般资料具有可比性。
1.2组织标本的采集所有入选对象均进行胃镜检查。胃镜检查取胃粘膜组织如下:胃窦2块(1块供病理检测,1块快速尿毒酶实验),胃体2块,供mrna测定和核蛋白测定。
1.3il1β、tnfα和nfκb mrna表达的检测
1.3.1rna的提取取将称量后的新鲜胃粘膜组织标本放入1000μl玻璃匀浆器中。加预冷的trizol 1000μl充分混匀,反复冰上碾磨,在15℃~30℃孵育5min使核定白复合物完全解离。加入氯仿200μl反复混匀30秒,离心(12000×g)15min。取上清离心(12000×g)10min,加入75%乙醇、室温干燥。加入40μl te缓冲液(ph=8.0)4℃过夜溶解rna(具体见文献5)。
1.3.2mrna的定量首先对组织标本进行重量测定,依据组织重量加rna溶解te缓冲液。然后在lambda10型分光光度计(pe公司)测定溶液a260/280,a260为1时相当于40μg/ml rna,最后依据如下公式计算mrna浓度(n为稀释倍数)。rna total=a260 ×40×n
1.3.3rtpcr扩增il1β的扩增产物为480bp[4]。扩增tnfα的引物序列为,p1:gagtgacaag cctgtagccc atgtt; p2:aagccctggt atgagcccat ctatct,扩增产物为336bp。扩增nfκb的引物序列为:p1:aagtgcgagg ggcgctccgc gggcag;p2:gagcagcgtg gggactacga cctga;扩增产物为403bp。rtpcr反应体系为50μl,使用promega公司accessquicktmrtpcr系统。具体pcr的循环次数由il1β、tnfα和nfκb和gapdh(为内参加,引物序列为p1:5'cacagtccatgccatcactg'3,p2:5'tactccttggaggccatgtg'3,扩增产物为480bp)的扩增量决定,每次采用循环次数梯度递减的方法,直到找出最少的必需循环次数。il1b rtpcr产物8μl以2.0%琼脂糖凝胶电泳,100v 25min,然后0.5μg/ml溴乙锭染色,紫外灯下观察结果,并在凝胶成像系统(gel doc 100 system,biorad公司)扫描电泳结果,计算il1mrna与gapdh mrna的光密度(od)的比值。
1.4nfκb活性的凝胶电泳迁移实验检测
1.4.1胃粘膜核蛋白提取使用核蛋白抽提试剂盒(thermo fisher scientific inc,rockford,usa),按产品说明书操作(稍有改变,):将称量后的胃粘膜组织的置于冰上碾碎,在匀浆中匀浆并500×g离心,弃上清后干燥细胞团,加0.2ml冰冷的胞浆蛋白裂解液ⅰ,冰上孵育10min。加11μl 冰冷的胞浆蛋白裂解液ⅱ,冰上孵育1min。再振荡5sec,离心16000g离心5min。迅速移出上清,上清液即为胞浆蛋白液,于-80℃保存备用。
1.4.2nfκb凝胶电泳迁移实验按照说明书进行nfκb探针(5′agttgaggggactttaggc3′,promega)标记。配制20ml 4%的聚丙烯酰胺凝胶。设置emsa结合阴性对照反应体系,阳性对照反应体系,特异性冷竞争反应,非特异性竞争反应,nfκb(p49或p50)反应体系。按照顺序依次加入各种试剂,混匀后立即上样。4%非变性丙烯酰胺凝胶电泳,用0.5×tbe作为电泳液。按照10v/cm的电压预电泳10min。电泳结束后,干胶仪器上干燥emsa胶。然后用x光片压片,然后检测光密度值。
1.5统计学方法计量资料以
2结果
2.1il1511基因多态性与tnfα和nfκb mrna表达量的关系在h.pylori阴性的个体,tnfα和nfκb mrna的表达量极少,在il1b511各基因型间il1β mrna的表达也无显著差异;在h.pylori阳性个体,tnfα和nfκb mrna有较为明显的表达,而且il1b511t/t基因型个体更明显;如图1、2所示。
2.2nfκb活性检测
进一步分析胃体组织nfκb的活性发现,h.pylori阴性的nfκb mrna活性很低,il1b511各基因型之间也无明显差异。然而,在h.pylori阳性个体,nfκb 活性显著增加。而且h.pylori阳性,il1b511t/t基因型个体nfκb 活性比c/t和c/c基因型明显增加,分别为0.99±0.12vs 0.89±0.15和0.90±0.14,f=5.6,p=0.005,见图3。lane 1: negative control;lane 2: positive control;lane 3: c/c genotype with h.pylori infection;lane 4: c/tgenotype with h.pylori infection;lane 5: t/t genotype with h.pylori infection;lane 6:t/t genotype without h.pylori infection;lane 7:a standard dna ladder.exposure time was 30 seconds with xray film
3讨论
癌症与炎症的联系首先由virchow1863年假设提出[7],近来逐渐得到了大量研究的支持。流行病学研究已经发现,慢性炎症患者对多种癌症易感,据估计,全世界范围内,感染和炎症反应与15%~20%的癌症死亡存在联系[1]。有很多慢性炎症的启动因素,包括微生物感染(如h.pylori感染与胃癌和胃粘膜淋巴瘤)、自身免疫疾病(炎症性肠病与结肠癌)和不知原因的炎症状态(前列腺炎和前列腺癌)都会增加癌症危险性。然而,感染h.pylori后的临床后果差异甚大,近年较普通接受的假说认为,宿主局部酸分泌状态是决定h.pylori感染后慢性胃炎类型的主要因素。当酸分泌处于较低水平,易发生全胃炎,有发展为胃粘膜萎缩和肠化的倾向,进而发生胃溃疡和胃癌的危险性较大[89]。el0mar 等[1]认为,il1b基因多态性与胃粘膜感染h.pylori时il1β的产生量有关,而后者具有很强的抑制胃酸分泌作用,但是,我们以前的研究未能发现il1b基因多态性→il1β↑→胃酸分泌↓的通路。所以,il1b基因多态性中,感染后的大量炎症信号的激活可能与胃癌发生有关。nfκb是刺激抗凋亡基因表达的主要转录因子,在静息的细胞中,nfκb被阻隔在细胞浆内,与iκbs等抑制性蛋白形成复合体,处于无活性状态,可以由活性氧化物、蛋白水解酶、透明质酸il1和tnfα等诱导活化nfκb[6]。目前已经发现,h.pylori感染后的胃粘膜微环境中,存在大量的前炎症因子的表达,如tnfα,il1β,il8和il6。虽然还不十分准确地知道前炎症因子如何在h.pylori感染后的胃癌发生中的机制,但我们知道tnfα也是一个关键的因素。主要的依据有:tnfα本身是很强的肿瘤启动因子,在体外可以诱导细胞发生转化[10]。在tnfα缺陷小鼠,佛波酯和冈田酸难以诱导皮肤癌的发生。已经有研究发现,在慢性炎症中il1β是诱导nfκb上调的原因,而nfκb激活是诱导tnfα表达的关键因素;当然,tnfα也可促进nfκb的激活。提示il1β,tnfα和nfκb之间并不是只有单向调节作用,还存在复杂的相互调节。本课题进一步对胃黏膜tnfα和nfκb mrna表达研究发现,在h.pylori阳性胃体粘膜,tnfα和nfκb mrna,以及nfκb的活化存在明显上调,而且il1b511t/t基因型的表达比其他基因型要高(p<0.05)。说明h.pylori感染后,存在il1b基因多态性→il1β↑→炎症细胞因子↑→胃癌发生的完整通路。值得提出的是,我们研究结果将来对胃癌预防有提示作用,即h.pylori感染后使用抑酸药物不一定不安全,而抗炎药物可能会减少胃癌的危险性[11]。
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