基于iTRAQ技术的发育性颈椎管狭窄与脊髓型颈椎病气虚血瘀证人群相关性的血清蛋白组学研究

CSM is a type of cervical spondylosis with the most severe symptoms and poor prognosis.Most of CSM patients developed from DCCS. The universally acknowledged of DCCS translated into CSM main way to improve curative effect is early diagnosis and intervention. Our previous research had found that dynamic cervical vertebra MRI can objectively identify participants with DCCS transform into CSM, and we intervened to make participants with DCCS delay the onset of CSM. The question is whether we can early identify participants with DCCS transform into CSM by finding some specific protein markers? It has been proved to be Qi deficiency and blood stasis syndrome is a common type of CSM by numerous literatures,whether participants with DCCS has deficiency of Qi and blood stasis syndrome should be more likely to transform into CSM(deficiency of Qi and blood stasis syndrome)?That’s exactly what we need to explore. With the development of proteomics research, this research plans to study DCCS and CSM syndrome of Qi deficiency and blood stasis of crowd,detect the fingerprint of serum protein by using the technology of iTRAQ and LC-MALDI-TOF/TOF,which finding the syndrome of differentially expressed serum proteins and validating them so that discovering the associations between DCCS and CSM.The subject also explore the molecular processes of participants with DCCS transform into CSM,which provides the theoretical basis for applying the intervention based on syndrome differentiation of traditional Chinese medicine.

脊髓型颈椎病(CSM)是症状最重、预后较差的一类颈椎病，CSM患者多由发育性颈椎管狭窄(DCCS)发展而来。对CSM早诊断、早干预是目前公认提高疗效的主要手段。我们前期研究通过动态颈椎MRI可辨别出早期DCCS转化为CSM患者，并在社区居家对DCCS人群进行干预可延缓其转化为CSM；能否通过发现某种特异性蛋白对DCCS人群进行辨识以揭示其转化为CSM的可能性？另外，文献表明气虚血瘀证是CSM最常见的证候，而DCCS人群中具有气虚血瘀证者转化为CSM(气虚血瘀证)的可能性较大？这都是值得探讨的。随着蛋白质组学研究的发展，本研究以DCCS和CSM中气虚血瘀证者为研究对象，运用iTRAQ结合LC-MALDI-TOF/TOF技术，检测该证型的血清蛋白指纹图谱，发现其证候的血清差异蛋白并进行验证，以找到两者的关联，并探讨DCCS转化为CSM的分子调控机制，为下一步应用中医药辩证干预本病提供理论依据。

脊髓型颈椎病(CSM)是症状最重、预后较差的一类颈椎病，CSM患者多由发育性颈椎管狭窄(DCCS)发展而来，与既往着眼与X线、CT、MRI辨别出早期DCCS转化为CSM患者相比，基于TMT技术筛查出的差异蛋白用于辨别早期DCCS转化为CSM更具有先进性、科学性。本项目基于TMT技术的DCCS与CSM（气虚血瘀证）人群相关性的血清蛋白组学研究,采用高通量的蛋白组学分析技术将DCCS（气虚血瘀证）、DCCS（非气虚血瘀证）、CSM（气虚血瘀证）患者、CSM（非气虚血瘀证）患者、非DCCS及CSM 的人群分别与正常健康人群对比，以及气虚血瘀证DCCS人群与CSM（气虚血瘀证）患者对比，获得差异蛋白，可以最大程度地得到蛋白质组的“全组信息”。本结果发现DCCS（气虚血瘀）与CSM（气虚血瘀）之间的差异蛋白,如Cdc42、ILK、FN1、ACTN1、ACTN4、MAPK13、VASP、ACTB等，这些差异蛋白可能是DCCS（气虚血瘀）与CSM（气虚血瘀）潜在特异生物标志物，从而揭示了 DCCS（气虚血瘀）向 CSM（气虚血瘀）转化的可能性及分子调控机制；同时结果还发现了CSM患者与正常人群之间的差异蛋白，揭示了CSM的潜在分子作用机制。本项目成果将为中医药预防DCCS（气虚血瘀）向 CSM（气虚血瘀）转化以及为精准干靶点预CSM提供理论依据。

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