| ObjectiveIt is to clarify the relationship between the protease activated receptors, PAR2 and PAR4, and patients with post-infective irritable bowel syndrome through the clinical symptoms scores and rectal sensation volume threshold, which will be as a index of the visceral sensitive in patients with PI-IBS, and studying the determination of PAR2 and PAR4 of intestinal mucosa in patients with PI-IBS and of the expression on intestinal mast cell. Thus we can broaden visceral high sensitivity happening mechanism of the disease of PI-IBS, and deepen the understanding of the disease, in order to further reveal mechanism of PI-IBS, and to guide clinical treatment effectively.Methods23 patients with PI-IBS who were diagnosed by the latest standard in domestic, excluded always peptic ulcer, chronic bacterium dysentery, thyroid disease, intestinal absorption bad syndrome, were as treatment group.17 healthy volunteers were as control group, who were excluded gastrointestinal tract disease before and ruled out acute inflammatory bowel disease this two weeks. The study included the following several parts:(1) the treatment group were evaluated for clinical symptoms scores based on abdominal pain; (2) the treatment group and control group were measured rectal sensation volume threshold by water pouring gasbag sensation conduit; (3) the treatment group and control group were extracted rectal mucous tissue as three samples for RT-PCR, by which PAR2mRNA and PAR4 mRNA are detected;and for immunohistochemistry by which mast cell and activated mast cell are counted, and by which the expressions of PAR2 and PAR4 on mast cell and rectal mucous were detected; and for double immunofluorescence, by which changes of PAR2 and PAR4 on activated mast cells were detected. All data were analyzed by the statistical test according to the related parameters and methods to determine.Results1, The first and largest rectal sensation volume threshold were lower obviously in treatment group than those in control group, it was specific significant, p<0.05。The intestinal sensitivity in patients with PI-IBS is higher than that of normal。2, Study were found by application RT-PCR technology:the expression of PAR2mRNA on rectal mucous was 4.317+/-0.154 in control group, while that was 5.027+/-0.126 in treatment group, so were no significant differences between those. The expression of PAR4mRNA on rectal mucous was5.528+/-0.153 in control group compared with that of 3.406 +/-0.172 in treatment group, p<0.05, and so was significant, that was to say, the expression of PAR4mRNA in rectal mucosa in patients with PI-IBS PAR4 is reduced, and there are significant differences.3, Study were found by application immunohistochemical techniques:the expression of PAR2 in colonic mucosal was 13.765+/-5.426 in control group compared with 14.609+/-6.111 in treatment group, and there were no significant differences between those that for PAR4 the expression was 11.529+/-4.679 in control group compared with 8.739+/-3.744 in treatment group, p<0.05, and that was significant different. The experiment confirmed that the expression of PAR4 on intestinal mucosa in patients with PI-IBS reduced, but the expression on intestinal mucosa in patients with PI-IBS did not change significantly.4, The experimental data show the number of mast cells in the control group was 5.172+/-1.245 compared with 6.141+/-1.490 in treatment group, p>0.05, and the statistics show no significant meaning. For the degranulation of mast cells, the number was 1.537+/-0.578 in the control group, compared with 2.832+/-1.186 in treatment group, p< 0.01, which had obvious meaning. Most of the mast cells exist PAR4 expression, and the expression of PAR4 was 67.706+/-12.479 in the control group,compared with 53.696+/-12.452 in treatment group, P <0.05, which has obvious meaning, and so the expression of PAR4 on mast cells in patients with PI-IBS decreased obviously.5, There was a correlation analysis between the expression of PAR4 on mast cells and clinical symptom scores and rectal sensation threshold and found that expression of PAR4 had no correlation with clinical symptom scores, while the expression of PAR4 and rectal sensation threshold had the positive correlation, p<0.01, and which will have a significant meaning. So we can conclude that PAR4 had a negative correlation with intestinal sensitivity.Conclusion1, The results indicate that there were correlation between rectal sensation volume threshold and clinical symptom scores, and along with the increase of clinical symptom scores, rectal sensation volume threshold reduced. The rectal sensation volume threshold of healthy people was obviously higher than that of in those patients with PI-IBS, which explained the intestinal sensitivity in patients with PI-IBS was increase.2, There were expression of PAR2 mRNA and PAR4 mRNA in the intestinal mucosa in patients with PI-IBS.By application RT-PCR technology and immunohistochemical technology research,we found that the PAR2 expression level had no significant difference in patients with PI-IBS and control group,while the PAR4 expression level was significantly lower in patients with PI-IBS than those in control group.3, The number of active degranulation mast cells on the intestinal mucosa of patients with PI-IBS was population. There were expression of PAR4 on the intestinal mucosa mast cells of patients with PI-IBS, and the PAR4 expression level reduced significantly compared with normal people4, There was a relationship between the intestinal sensitivity in patients with PI-IBS and the changes of PAR4 expression level, and the reduce of expression of PAR4 may increase the internal sensitivity of patients with PI-IBS... |
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