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標題: 利用PAR-2基因來提早診斷巴雷特氏食道症和其他發炎因子的相關性
To use PAR - 2 gene to early diagnosis of Barrett's esophagus and other inflammatory factors Correlation.
作者: 陳葦瑜
Wei-Yu Chen
關鍵字: 巴雷特氏食道;蛋白酶活化受體-2;Barrett's esophagus (BE);Protease-activated receptor -2 (PAR-2)
引用: 1. Craig S Brown and Michael B Ujiki Risk factors affecting the Barrett's metaplasia-dysplasia-neoplasia sequence World J GastrointestEndosc. 2015 May 16; 7(5): 438–445. 2. Yuji Amano, MD, PhDand Yoshikazu Kinoshita, MD, PhD Barrett Esophagus Perspectives on Its Diagnosis and Management in Asian Populations Gastroenterol Hepatol (N Y). 2008 Jan; 4(1): 45–53. 3. Hyun Seok Lee and Seong Woo Jeon Barrett Esophagus in Asia: Same Disease with Different Pattern ClinEndosc. 2014 Jan; 47(1): 15–22. 4. Spechler SJ , Sharma P, Souza RF, Inadomi JM, Shaheen NJ; American Gastroenterological Association. American Gastroenterological Association technical review on the management of Barrett's esophagus. Gastroenterology. 2011 Mar; 140(3):e18-52; quiz e13. 5. Song Han, Constance W. Lee, Jose G. Trevino,1 Steven J. Hughes, and George A. Sarosi, Jr Arun Rishi, Editor Autocrine Extra-Pancreatic Trypsin 3 Secretion Promotes Cell Proliferation and Survival in Esophageal Adenocarcinoma PLoS One. 2013; 8(10): e76667. 6. Kenneth K. Wang, M.D. and Richard E. Sampliner, M.DUpdated Guidelines 2008 for the Diagnosis, Surveillance and Therapy of Barrett's Esophagus. Am J Gastroenterol 2008;103:788–797 7. Eric M. Nelsen, MD, Robert H. Hawes, MD, and Prasad G. Iyer, MD, MS Diagnosis and Management of Barrett's Esophagus Surg Clin North Am. 2012 Oct; 92(5): 1135–1154. 8. Lori A. Fischbach, MPH, PhD, David Y. Graham, MD, Jennifer R. Kramer, MPH, PhD, Massimo Rugge, MD, Gordana Verstovsek, MD, Paola Parente, MD, Abeer Alsarraj, MS, Stephanie Fitzgerald, BS, Yasser Shaib, MD, MPH, Neena S. Abraham, MD, MS, Anna Kolpachi, MD, Swapna Gupta, MD, Marcelo F. Vela, MD, Maria Velez, MD, Rhonda Cole, MD, Bhupinderjit Anand, MD, and Hashem B. El Serag, MD, MPH Association between Helicobacter pylori and Barrett's Esophagus: A Case–Control Study Am J Gastroenterol. 2014 Mar; 109(3): 357–368. 9. Nathalie Vergnolle Protease-activated receptors and inflammatory hyperalgesia Oswaldo Cruz vol.100 suppl.1 Rio de Janeiro Mar. 2005 10. Ping Yue , Barry M. Massie , Paul C. Simpson , Carlin S. Long. American Journal of Physiology - Heart and Circulatory Physiology Published 1 July 1998 Vol. 275 no. 1,Cytokine expression increases in nonmyocytes from rats with postinfarction heart failure. 11. Norimasa Yoshida Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto 602-8566, Japan Inflammation and Oxidative Stress in Gastroesophageal Reflux Disease. 12. Sharma P, Dent J, Armstrong D, Bergman JJ, Gossner L, Hoshihara Y, Jankowski JA, Junghard O, Lundell L, Tytgat GN, Vieth M. The development and validation of an endoscopic grading system for Barrett's esophagus: the Prague C & M criteria. Gastroenterology. 2006 Nov; 131(5):1392-9. 13. Mem. Inst. Oswaldo Cruz vol.100 suppl.1 Rio de Janeiro Mar.2005 Protease-activated receptors and inflammatory hyperalgesia 14. Michele Ammendola, Christian Leporini, IlariaMarech, Cosmo Damiano Gadaleta, Giovanni Scogn millo, Rosario Sacco, Giuseppe Sammarco, Giovambattista De Sarro, Emilio Russo, and Girolamo Ranieri Targeting Mast Cells Tryptase in Tumor Microenvironment: A Potential Antiangiogenetic Strategy Biomed Res Int. 2014; 2014: 154702. 15. Ducroc R, Bontemps C, Marazova K, Devaud H, Darmoul D, Laburthe Trypsin is produced by and activates protease-activated receptor-2 in human cancer colon cells: evidence for new autocrine loop.Life Sci. 2002 Feb 8;70(12):1359-67.
巴雷特氏食道症(Barrett's esophagus)為食道腺癌(esophageal adenocarcinoma)的一種癌前狀態。每年約有0.5%的病人,是由巴雷特氏食道症演變成食道腺癌的狀況。目前在食道醫學,巴雷特氏食道的病人,在病徵輕微極易被忽略;然而,需就醫時,經常已出現嚴重的症狀。在就醫方面主要根據病人敘述的臨床症狀、食道內視鏡檢查食道細胞及病理切片檢查。診斷依據主要為內視鏡有食道化生(endoscopic suspected esophageal metaplasia),及食道鱗狀上皮細胞(squamous epithelium)被柱狀細胞(columnar epithelium)取代的情形,且有杯狀細胞(goblet cells)產生。目前來說,只能使用內視鏡及切片來協助診斷。蛋白酶激活受體-2(Protease activated receptor 2,PAR-2)在巴雷特氏食道症的表現情形,來做為前瞻性協助診斷的生物標記。本研究使用即時定量聚合酶鏈鎖反應(real-time PCR)檢測在巴雷特氏食道及其他部位的表現量,結果發現PAR-2在巴雷特氏食道的表現量大於正常食道。利用細胞激素與PAR-2做相關性檢測,可得知病人處於發炎期或非發炎期。PAR-2可能是一個很好的生物標記物,可用來協助診斷及追蹤巴雷特氏食道症,在這次實驗中細胞激素對於巴雷特氏食道症的表現,結果顯示IL-10、IL-24、IL-3、COX-2在食道化生區的表現量大於正常食道。除此之外藉由PAR-2與IL-10及PAR-2與COX-2之間的正相關性,我們可以得知胃食道逆流症是一個巴雷特氏食道症的一個因素,其中胰蛋白酶(trypsin)的分泌活化更多的PAR-2,導致病人處於發炎反應,並有可能長期造成鱗狀上皮化生成柱狀上皮的機率升高。另外IL-10與PAR-2的正相關性來進一步得知發炎期的狀態及巴雷特氏症病人的嚴重程度。

Barrett's esophagus (BE) is precancerous condition of Esophageal Adenocarcinoma (EAC, very often deadly cancer). Every year, about 0.5% of the patients evolved from BE to Esophageal Adenocarcinoma situation. The medicine science to the BE, the patients is easily ignored when the symptom is mild, however when they need for medical treatments, the symptom often becomes serious. In terms of medical examination of the esophagus, they according to the patient described, and doctor were execute esophageal endoscopy and biopsy mainly based on clinical symptoms. The diagnosis of BE is established by endoscopic suspected esophageal metaplasia and replacement of esophageal squamous epithelium by columnar epithelium cells with goblet cells (intestinal metaplasia IM). For now, there were two methods to use endoscopic and biopsy diagnosis BE. This study was designed to compare the different expression of Protease-activated receptor -2 (PAR-2), a potential biomarker for assay the Barrett's esophagus and EAC. Using real-time polymerase chain reaction to quantitative the PAR-2 expression in BE. We found out that the expression of PAR-2 with BE and stomach were all significantly higher than normal esophagus. By measuring cytokines include interleukin-10, interleukin-24, interleukin-3, Cyclooxygenase-2. We can know that the patient is under the non-inflammatory period or inflammatory period. Protein activated receptor-2 protein may be a good biomarker which can be used to help us to diagnose and manage BE.
其他識別: U0005-1408201512494800
Rights: 同意授權瀏覽/列印電子全文服務,2017-08-19起公開。
Appears in Collections:生命科學院碩士在職專班

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