燃煤型氟中毒病区人群血清中基质金属蛋白酶与氟斑牙关系
Relationship between Serum Matrix Metalloproteinases and Dental Fluorosis in Residents of Endemic Area of Coal Burning Induced Fluorosis
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摘要:
目的 探讨氟暴露人群血清中基质金属蛋白酶(MMP-2、MMP-9、MMP-13)活性变化与氟斑牙的关系。 方法 选择贵州省清镇市流长乡燃煤型氟中毒病区191 例氟暴露者为调查对象,根据人群尿氟实际检测结果范围,将病区氟暴露者分为4 组:<1.2 mg/gCr(95 例)、1.2 mg/gCr~(43 例)、1.8 mg/gCr~(24 例)和2.4 mg/gCr~(29 例);为了解其与氟斑牙程度的关系,根据氟斑牙临床分类诊断标准将氟暴露人群分为正常组(34 例)、可疑+ 极轻组(37 例)、轻度组(33例)、中度组(56 例)、重度组(31 例)。采用氟离子电极法测定氟暴露人群尿氟含量,酶联免疫吸附法(ELISA)检测血清样本中MMP-2、MMP-9、MMP-13 的活性。 结果 ①随着氟暴露人群尿氟水平增高,MMP-2、MMP-9、MMP-13 的活性逐渐增高,其中尿氟1.2 mg/gCr~、1.8 mg/gCr~和2.4 mg/gCr~组的MMP-2、MMP-9、MMP-13 活性与<1.2 mg/gCr 组比较,差异有统计学意义(P < 0.05);尿氟2.4 mg/gCr~组与1.2 mg/gCr~组比较,差异有统计学意义(P < 0.05)。尿氟2.4 mg/gCr~组MMP-2和MMP-9 的活性与1.8 mg/gCr~组比较,差异有统计学意义(P < 0.05)。②随着氟暴露人群氟斑牙程度的加重,MMP-2、MMP-9、MMP-13 的活性逐渐增高,其中氟斑牙重度、中度组与正常组比较,差异有统计学意义(P < 0.05);重度组与可疑+ 极轻度组间差异有统计学意义(P < 0.05)。③氟暴露人群尿氟与MMP-2、MMP-9、MMP-13 活性呈正相关(r=0.808、r=0.795、r=0.790,P < 0.05);氟斑牙程度与MMP-2、MMP-9、MMP-13 活性呈正相关(r=0.332、r=0.358、r=0.316,P < 0.05)。 结论 氟可能通过诱导MMP-2、MMP-9、MMP-13 活性增高,影响骨代谢,进而导致氟斑牙的发生发展。 Abstract:Objective To explore the relationship between serum matrix metalloproteinases (MMP-2, MMP-9, and MMP-13) expressions and dental fluorosis in fluorine exposed population. Methods A total of 191 individuals were selected from an area of endemic fluorosis in Guizhou Province. Urinary fluoride level was quartilized based on the range of urinary fluoride in local population (<1.2 mg/gCr, 95 cases; 1.2 mg/gCr~, 43 cases; 1.8 mg/gCr~, 24 cases; and 2.4 mg/gCr~, 29 cases). The participants were classified as normal (34 cases), suspect+very mild (37 cases), mild (33 cases), moderate (56 cases), and severe (31 cases) according to the diagnostic criteria of dental fluorosis. Urinary fluoride concentrations were determined by ion-selective electrode. Serum levels of MMP-2, MMP-9, and MMP-13 were measured by enzyme-linked immunosorbent assay (ELISA). Results ① The expression of MMP-2, MMP-9, and MMP-13 increased gradually with the increasing of urinary fluoride level. There were significant differences in MMP-2, MMP-9, MMP-13 expressions between Groups 1.2 mg/gCr~, 1.8 mg/gCr~, 2.4 mg/gCr~ and Group <1.2 mg/gCr (P < 0.05), and between Group 2.4 mg/gCr~ and Group 1.2 mg/gCr~ (P < 0.05). The expression levels of MMP-2 and MMP-9 in Group 2.4 mg/gCr~ were significantly different from Group 1.8 mg/gCr~ (P < 0.05). ② The severity of dental fluorosis increased significantly with the increase of MMP-2, MMP-9, and MMP-13 expressions. Compared with the normal group, MMP-2, MMP-9, MMP-13 was increased significantly in the moderate and the severe groups (P < 0.05). Significant differences were also found between the severe group and the suspect+very mild group (P < 0.05). ③ Urinary fluoride concentrations were positively correlated with the expression levels of MMP-2, MMP-9, and MMP-13 (r=0.808, r=0.795, and r=0.790, respectively, P < 0.05). The severity of dental fluorosis were positively correlated with the MMP-2, MMP-9, and MMP-13 activity (r=0.332, r=0.358, and r=0.316, respectively, P < 0.05). Conclusion Through the induction of MMP-2, MMP-9, and MMP-13 expressions, fluorine can intervene the regulation of bone metabolism and lead to development and progression of dental fluorosis.
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