자연 기흉 환자의 혈액 내 TGF-beta 1 Ligand 양과 폐 기포 형성과의 연관관계에 대한 연구

Background: The overexpression of transforming growth factor-beta 1 receptor Ⅱ (TGF-β1RⅡ) and transforming growth factor-beta 1 (TGF-β1) ligand may be involved in the formation of a bulla. In this study, we tested if serum TGF-β1 ligand levels correlated with the expression level of TGF-β1RⅡ and TGF-β1 in bullous tissues from patients with spontaneous pneumothorax. Material and Method: Bullous lung tissues and blood samples were obtained from 19 patients with spontaneous pneumothorax, 18 males and 1 female, aged 17 to 35 years old. The bullous tissues were obtained by video-assisted thoracic surgery (VATS), fixed in formalin, embedded in paraffin, and cut into 5~6㎛ thick slices. Sections were immunohistochemically stained with primary antibodies against TGF-β1 or TGF-β1RII, and serum levels of TGF-β1 in patients and normal controls was measured by enzyme-linked immunosorbent assay (ELISA). Result: Of the 19 patients, 16 were TGF-β1 positive and 10 were TGF-β1RⅡ positive. Among the 16 TGF-β1 positives, 9 were also TGF-β1RⅡ positive. As seen previously, strong immunohistochemical staining of TGF-β1RⅡ and TGF-β was detected in the boundary region between the bullous and normal lung tissues. Average TGF-β1 blood levels of both TGF-β1 and TGF-β1RⅡ positive patients was 38.36±16.2 ng/mL, and that of five controls was 54.06±15 ng/mL. Conclusion: These results suggest that overexpression of TGF-β1 and TGF-β1RⅡ expression may be involved in the formation of bullae. TGF-β1 blood levels in patients with primary spontaneous pneumothorax is lower than normal people, suggesting that the high level of local TGF-β1 expression in the bullous tissue region, but not in the whole blood, may contribute more in the formation of bullae.