摘要目的 探讨P-糖蛋白、多药耐药相关蛋白和穹隆主蛋白3种蛋白在难治性癫痫相关病变脑组织中的分布、表达部位及其在难治性癫痫发生过程中所发挥的作用.方法 取18例难治性癫痫患者(包括局灶性皮质发育不良5例、结节性硬化3例、神经节细胞胶质瘤5例、胚胎发育不良性神经上皮瘤5例)致痫灶手术切除脑组织标本,利用针对上述3种蛋白的抗体进行免疫组织化学EnVision法染色.结果 P-糖蛋白主要表达于病灶区域的毛细血管内皮细胞内,多药耐药相关蛋白的表达部位则主要为病灶区域内的神经元成分,而穹隆主蛋白在病变脑组织中的高度表达主要集中于毛细血管内皮细胞和气球细胞,另有部分神经元成分呈弱阳性表达.此外,P-糖蛋白和穹隆主蛋白在肿瘤性病变病灶区域毛细血管内皮细胞中的表达强于非肿瘤性病变,而在神经节细胞胶质瘤和胚胎发育不良性神经上皮瘤的肿瘤性胶质细胞中,多药耐药相关蛋白和穹隆主蛋白的表达情况也不尽相同.结论 P-糖蛋白、多药耐药相关蛋白和穹隆主蛋白均参与了难治性癫痫的发生过程,其表达部位不同,作用机制各异.

abstractsObjective To study the expression of P-glycoprotein,multi-drug resistance associated protein and major vault protein in pathologic brain specimens,and to investigate their roles in the pathogenesis of refractory epilepsy.Methods Immunohistochemical study was performed in pathology specimens from 18 cases of refractory epilepsy(including 5 cases of focal cortical dysplasia,3 cases of tuberous sclerosis,5 cases of ganglioglioma and 5 cases of dysembryoplastic neuroepithelial tumor).Results Both the P-glycoprotein and major vault protein were localized in microvascular endothelium of the lesions.Major vault protein was also seen in balloon cells and some neuronal cells.On the other hand,multi-drug resistance associated protein Was mainly localized in the neuronal component of the lesions.In general,the expression of P-glycoprotein and major vault protein in tumoral tissue Was higher than that in non-tumoral tissue.The expression of multi-drug resistance associated protein and major vault protein was also different in the neoplastic glial cells of ganglioglioma and dysembryoplastic neuroepithelial tumor.Conclusions P-glycoprotein,multi-drug resistance associated protein and major vault protein contribute to the pathogenesis of refractory epilepsy.They may however have different roles,with different cellular localization.