CAJ | 학술논문

目的探讨Fas抗原与Fas配体(FasL)及可溶性Fas(sFas)在川崎病(KD)发病中的作用及临床意义.方法应用流式细胞仪对急性期和缓解期KD患者外周血淋巴细胞(PBLC)上Fas和FasL的表达情况进行了检测,用双抗体夹心酶联免疫吸附试验(ELISA)检测KD患者急性期和缓解期血清sFas的含量.同时检测红细胞沉降率(ESR)、C反应蛋白(CRP).结果急性期KD患者PBLC上Fas和FasL的表达分别为(14.2±0.5)%和(1.61±0.09)%,较缓解期KD(15.7士0.5)%和(1.95±0.09)%显著降低(P<0.05和P<0.01),急性期和缓解期KD患者PBLC上Fas表达较健康对照组(20.8±0.5)%显著降低(P均<0.01);急性期和缓解期患者PBLC上FasL的表达较健康对照组(2.38±0.10)%显著降低(P均<0.01);急性期和缓解期KD患者血清中sFas水平分别为(1906±55)μg/L和(1622±52)μg/L,明显高于健康对照组(1151±51)μg/L(P均<0.01),急性期sFas明显高于缓解期(P<0.01).sFas与ESR、CRP呈正相关(P均<0.01).结论 KD患者PBLc上Fas/FasL及循环sFas的表达均有异常,表现为Fas/FasL均下降,sFas增高,提示淋巴细胞Fas/FasL异常表达及Fas介导的细胞凋亡可能与KD的免疫异常及发病有关,sFas可作为病情活动性和治疗效果评价的指标.
목적 탐토Fas항원여Fas배체(FasL)급가용성Fas(sFas)재천기병(KD)발병중적작용급림상의의.방법 응용류식세포의대급성기화완해기KD환자외주혈림파세포(PBLC)상Fas화FasL적표체정황진행료검측,용쌍항체협심매련면역흡부시험(ELISA)검측KD환자급성기화완해기혈청sFas적함량.동시검측홍세포침강솔(ESR)、C반응단백(CRP).결과 급성기KD환자PBLC상Fas화FasL적표체분별위(14.2±0.5)%화(1.61±0.09)%,교완해기KD(15.7사0.5)%화(1.95±0.09)%현저강저(P<0.05화P<0.01),급성기화완해기KD환자PBLC상Fas표체교건강대조조(20.8±0.5)%현저강저(P균<0.01);급성기화완해기환자PBLC상FasL적표체교건강대조조(2.38±0.10)%현저강저(P균<0.01);급성기화완해기KD환자혈청중sFas수평분별위(1906±55)μg/L화(1622±52)μg/L,명현고우건강대조조(1151±51)μg/L(P균<0.01),급성기sFas명현고우완해기(P<0.01).sFas여ESR、CRP정정상관(P균<0.01).결론 KD환자PBLc상Fas/FasL급순배sFas적표체균유이상,표현위Fas/FasL균하강,sFas증고,제시림파세포Fas/FasL이상표체급Fas개도적세포조망가능여KD적면역이상급발병유관,sFas가작위병정활동성화치료효과평개적지표.
Objective To explore the effect of Fas, Fas ligand (FasL), soluble Fas (sFas) and their clinical significance in KD. Methods The expression of Fas, FasL in peripheral blood lymphocytes (PBLC) were detected with flow cytometery at acute and remission stages in patients with KD; and the serums Fas was detected by double antibody sandwich ELISA in the patients with KD at acute and remission stage, meanwhile erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) were also tested. Results The expression of Fas, FasL in PBLC in patients with KD at acute stage was (14.2±0.5)% and (1.61±0.09)% respectively , which were significantly lower than those at remission stage [(15.7±0.5)%, (1.95±0.09)% respectively (P<0.05 and P<0.01)]. The expression of Fas in PBLC in the patients with KD at acute and remission stage was both significantly lower than that in normal control group (20.8±0.5)% (P<0.01 both);The expression of FasL in PBLC in patients with KD at acute and remission stage was both significantly lower than that in normal control group (20.8±0.5)% (P<0.01 both); the serum sFas in patients with KD at acute and remission stage was (1906±55)μg/L and (1622±52)μg/L respectively , which was significantly higher than that in normal control group (1151±51)μg/L (P<0.01 both); the serum sFas at acute stage was obviously higher than that at remission stage (P<0.01); there was positive correlation between sFas and ESR, CRP (P<0.01 both). Conclusion There are abnormal expressions of Fas/FasL in PBLC and sFas in patients with KD. Fas/FasL is lower and sFas is higher than that of the controls. The abnormal expression of Fas/ FasL in lymphocytes and the apoptosis triggered by sFas are probably involved in the immunological aberrance and pathogenesis of KD. sFas may be used as a marker to evaluate the disease activity and therapeutic efficacy.