The Expression And Clinical Significance Of A-sma And Fbn-1in Rheumatic Mitral Valve Disease

Background Valvular heart disease (VHD) is due to inflammation, myxoid degeneration, degenerative change, congenital malformation, avascular necrosis, trauma and causes of valve structure change, making the disc mouth a narrow and (or) closed due to the heart disease. In our country, Rheumatic heart disease (RHD) is the most common, due to the valve damage in the rheumatic inflammatory process,and mitral involved in the most significant (about70%),tends to occur in patients with Age below40years old, the morbidity of which was decreased markedly in the last40years,was still one of the most common heart disease in China. Because rheumatic fever caused the abnormalities of mitral valve structure or function, which lead to cardiac hemodynamic changes, a series of clinical symptoms that appear thereby and body are asked for. The extensively hyperplasia, degeneration of the collagen fiber, damage and calcification of elastic fiber among valve interstitial, and so on, a series of extracellular matrix (ECM) change lead to valve stenosis or (and) regurgitation, thus cause hemodynamics abnormality, are performance characteristics of VHD, but the onset of the molecular mechanism and pathological form happening mechanism is entirely unknown. So the valve mesenchymal cells as ale tissue pathology change of main representative composition have become the research focus in recent years.Objective To analyze the phenotype transform rule of valve stromal cellular in the rheumatic heart disease, and research its relationship with the reason of valve pathological form occurred. This experiment research is to analyze expressions of a-smooth muscle actin (α-SMA)and Fibrillin-1(FBN-1)in the Rheumatic mitral valve disease, to investigate relationship between both and the valve pathological form occur, and clinicopathologic factors of chosed patients,and analyze the occurrence of rheumatic mitral valve mechanism, and to obtain the theoretical basis for diagnosis and treatment.Materials and Methods1.60cases of Rheumatic mitral were from the department of Cardiac Surgery of Henan Provincial Chest Hospital from October,2010to July,2011,and were confirmed after rheumatic mitral valve pathology.10cases of normal mitral valve tissues, Accidental death for the same period, no cardiovascular disease in the control group, provided by the Department of Forensic Medicine, Xinxiang Medical University.2. Immunohistochemical (immunohistochemistry,IHC) adopt the SABC methods,and immunohistochemical stain according to the SABC kit instructions.These60cases of Rheumatic mitral valve disease,10cases of normal mitral tissues were immunehistochemi-cally stained with a-SMA and FBN-1monoclonal antibodies. The positive expression rate and expression intensity of α-SMA and FBN-1protein were evaluated.3. Analysis of a-SMA and FBN-1protein expression and the relationship between the morphogenesis of valvular pathology and clinical pathological features.4. SPSS17.0for statistical software was used to analyze data. According to the material type, chi-square test analysis were used in statistical processing. The significant difference was considered when the P value was less than0.05.Results1. a-SMA was mainly expressed in cytoplasm, which was tan-yellow or brown, uneven distribution (cluster shape).Compared Rheumatic mitral with normal valve, a-SMA positive expression was significantly up-regulated(χ2=11.181,P=0.001,P<0.05). Because of the differences of valve calcification,thicken,contracture degree,the positive expression of a-SMA was significantly different, and the difference was statistically significant(type I and II,χ2=4.390, P=0.036;typeⅡandⅢχ2=3.883,P=0.049; type I andⅢ, χ2=13.093,P=0.000, P<0.05),while which does not relate to age and sex. 2. FBN-1was mainly expressed in ECM, which was tan-yellow. Compared Rheumatic mitral with normal valve, FBN-1positive expression was significantly up-regulated(χ2=9.740,P=0.002,P<0.05).Because of the differences of valve calcification, thicken,contracture degree,the positive expression of FBN-1was significant different, and the difference was statistically significant(type I and II,χ2=4.597,P=0.032;type II and III, χ2=4.912,P=0.027;type I and III,χ2=15.111,P=0.000,P<0.05), while which does not relate to age and sex.Conclusions1.In Rheumatic mitral, the expression of a-SMA expression was positively correlated with the expression of valve calcification,thicken,contracture degree.There were statistical significance. while which does not relate to age and sex.2.In Rheumatic mitral, the expression of FBN-1expression was positively correlated with the expression of valve calcification,thicken,contracture degree.There were statistical significance. while which is not any relationship with age and sex.