中国全科医学2024,Vol.27Issue(21) :2639-2645.DOI:10.12114/j.issn.1007-9572.2023.0623

Zeste同源物2增强子在桥本甲状腺炎B淋巴细胞亚群中的表达及其抑制剂的治疗机制及效果研究

EZH2 Expression in B Cell Lymphocyte Subsets of Hashimoto's Thyroiditis and the Therapeutic Mechanism and Effect of Its Inhibitors

易圣果 曹业迪 赵雪 卢桂芝 张杨 丛铁川 张澜波 张继新 梁振威 屈晨雪 张俊清 高莹
中国全科医学2024,Vol.27Issue(21) :2639-2645.DOI:10.12114/j.issn.1007-9572.2023.0623

Zeste同源物2增强子在桥本甲状腺炎B淋巴细胞亚群中的表达及其抑制剂的治疗机制及效果研究

EZH2 Expression in B Cell Lymphocyte Subsets of Hashimoto's Thyroiditis and the Therapeutic Mechanism and Effect of Its Inhibitors

易圣果 1曹业迪 1赵雪 1卢桂芝 1张杨 1丛铁川 2张澜波 3张继新 4梁振威 5屈晨雪 6张俊清 1高莹1
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作者信息

  • 1. 100034 北京市,北京大学第一医院内分泌内科
  • 2. 100034 北京市,北京大学第一医院耳鼻咽喉-头颈外科
  • 3. 100034 北京市,北京大学第一医院甲状腺乳腺外科
  • 4. 100034 北京市,北京大学第一医院病理科
  • 5. 100034 北京市,北京大学第一医院超声医学科
  • 6. 100034 北京市,北京大学第一医院检验科
  • 折叠

摘要

背景 甲状腺自身抗体是诊断桥本甲状腺炎(HT)的标志,B淋巴细胞在HT的发病机制中发挥重要作用.Zeste同源物 2 增强子(EZH2)是一种表观遗传学蛋白,在淋巴细胞的发育与功能调控中扮演重要角色.目的 本研究探讨EZH2在HT甲状腺组浆母细胞及浆细胞中的表达,进一步探讨EZH2抑制剂在实验性自身免疫甲状腺炎(EAT)模型中的治疗作用.方法 收集北京大学第一医院 2010-2020 年 6 例行甲状腺手术的患者,取肿瘤对侧的甲状腺组织(HT及正常甲状腺组织各 3 例),通过RNA-seq筛选B淋巴细胞相关基因的表达情况;收集 16 例HT患者的甲状腺组织和 8 例健康对照(HD)甲状腺组织,分别利用免疫组化及免疫荧光验证EZH2 在HT甲状腺组织中B淋巴细胞中的表达;收集 25 例HT甲状腺细针穿刺液(FNA)、19 例HT外周血以及 12 例健康人外周血样本应用流式细胞分析检测EZH2 在浆母细胞及浆细胞中的表达改变.将 15 只 7 周龄NOD.H-2h4 小鼠EAT模型分为对照组(n=5)、EAT无注射(n=5)或注射EZH2 抑制剂GSK126 处理组(10 mg/kg,腹腔注射 3 次/周,n=5),8 周后观察甲状腺炎症程度及甲状腺球蛋白抗体(TgAb)水平的改变.结果 RNA-seq结果显示,相较于正常甲状腺组织,HT甲状腺组织中EZH2 水平上调,一些与B淋巴细胞表型相关的基因例如CD19、CD27、CD38、CD52 相应增加.免疫组化结果显示,16 例HT甲状腺组织标本中EZH2 免疫组化染色均可在生发中心(GC)见到阳性细胞,呈强阳性,8 例正常甲状腺组织染色中未观察到阳性细胞.HT甲状腺组织中EZH2染色高表达在GC区,EZH2特异性地表达在CD19+B淋巴细胞中.流式细胞术检测结果显示HT FNA样本中CD19+B淋巴细胞、浆母细胞及浆细胞比例均高于HD外周血、HT外周血样本(P<0.01),HT FNA样本中EZH2 在CD19+B淋巴细胞、浆母细胞中的阳性比例高于HT外周血(P<0.005).小鼠实验中,EAT组甲状腺的淋巴细胞浸润较对照组增加.GSK126 处理组炎症程度评分和TgAb水平高于对照组,低于EAT组(P<0.001).结论 EZH2 在HT甲状腺组织CD19+B淋巴细胞中表达异常升高,可能促进了B淋巴细胞分化成浆细胞进而促进自身抗体生成破坏甲状腺,EZH2 抑制剂可以减缓EAT模型甲状腺炎症程度.浆母细胞中EZH2 表达增加可能参与了HT的发病机制,EZH2 可能成为治疗HT的新靶点,相关机制需要进一步深入研究.

Abstract

Background Thyroid autoantibody is a marker for the diagnosis of Hashimoto's thyroiditis(HT),and B cells are essential in the pathogenesis of HT.Enhancer of Zeste homolog 2(EZH2),which is an important epigenetic regulator,plays an important role in the regulation of lymphocytes development and function.Objective To investigate EZH2 expression in plasmoblasts and plasma cells in HT,and further explore the therapeutic effect of EZH2 inhibitors in experimental autoimmune thyroiditis(EAT)model.Methods The thyroid tissues from 6 patients who underwent thyroidectomy(3 HT patients with PTC,3 patients with PTC alone)in Peking University First Hospital between 2010 and 2020 were obtained from the contralateral lobe with thyroid cancer,and screened for the expression of B-lymphocyte-related genes by RNA-seq;thyroid tissues from 16 HT patients and 8 normal thyroid tissues were collected and verified for the the expression of EZH2 in B cells in HT thyroid tissues by immunohistochemistry or immunofluorescence,respectively.Fine-needle aspiration(FNA)samples from patients with HT(n=25),and peripheral blood from patients with HT(n=19)or healthy donors(n=12)were analyzed by flow cytometry to define altered EZH2 expression in plasmablasts and plasma cells.Fifteen seven-week-old NOD.H-2h4 mice were randomly divided into the control(n=5),EAT without injection group(n=5),and EZH2 inhibitor+ GSK126 injection group(10 mg/kg,intraperitoneal injection 3 times/week,n=5).The degree of thyroid inflammation and changes in TgAb levels were observed after 8 weeks.Results RNA sequencing analysis showed that EZH2 and genes associated with the B-cell phenotype such as CD19,CD27,CD38,CD52 were higher expressed in HT hyroid tissues compared with normal thyroid tissues.Immunohistochemical results showed that immunohistochemical staining for EZH2 in 16 HT thyroid tissue specimens was strongly positive with positive cells observed in the GC region,and no positive cells were observed in the staining of 8 normal thyroid tissues.EZH2 staining in HT thyroid tissue was highly expressed in the GC region,and EZH2 was specifically expressed in CD19+ B cells.The results of flow cytometry assay showed that the proportion of CD19+ B cells,plasmablasts and plasma cells in HT FNA samples was higher than that of HD peripheral blood and HT peripheral blood samples(P<0.01),and the proportion of EZH2 positivity in CD19+ B cells and plasma cells was higher in HT FNA samples than that of HT peripheral blood(P<0.005).In the mouse experiments,lymphocytic infiltration of the thyroid tissues was increased in the EAT group compared to the control group.In the GSK126 treatment groups,the thyroid inflammatory score and serum TgAb titer were significantly higher than the control group and lower than the EAT group.Conclusion EZH2 over-expression in CD19+ B cells of HT hyroid tissues may promote the differentiation of B cells into plasma cells and auto-antibody production,which leads to the destruction of thyroid tissues.EZH2 inhibitors can slow down the degree of thyroid inflammation in the EAT model.Increased EZH2 expression in plasmablasts may be involved in the pathogenesis of HT.EZH2 may serve as a therapeutic target for HT,although further studies are needed.

关键词

桥本甲状腺炎/B淋巴细胞亚群/Zeste同源蛋白2增强子/甲状腺功能减退症/靶向治疗

Key words

Hashimoto thyroiditides/B-lymphocyte subsets/Enhancer of Zeste homolog 2 protein/Hypothyroidism/Targeted therapy

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基金项目

国家自然科学基金面上项目(8217030553)

出版年

2024
中国全科医学
中国医院协会

中国全科医学

CSTPCD北大核心
影响因子:2.04
ISSN:1007-9572
参考文献量23
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