CAJ | 학술논문

目的了解不同程度支气管哮喘(简称哮喘)患儿白细胞15-脂氧化酶、5-脂氧化酶、血液脂氧素A4(lipoxin A4,LXA4)及白三烯C4(leukotriene C4,LTC4)水平的变化.方法根据哮喘诊断标准及分度标准选取哮喘患儿106例作为哮喘组,检测前4周均无感染性疾病或其他脏器疾病;选取既往健康的学校体检正常儿童40名作为对照组.应用RT-PCR方法测定急性发作期的轻、中、重度哮喘息儿血白细胞15-脂氧化酶、5-脂氧化酶的mRNA表达,应用ELISA方法测定哮喘患儿血液LXA4、LTC4含量.观察患儿在吸入速效β2受体激动剂后的呼气峰流速(PEF)及FEV1与血液LXA4及LTC4的关系.结果轻、中、重度哮喘息儿白细胞15-脂氧化酶相对表达量分别为1.78±0.56、1.28±0.45和0.58±0.22(F=16.72,P<0.01),血液LXA4分别为(5.52±1.97)、(1.86±0.72)和(0.81±0.36)μg/L(F=22.59,P<0.01),均逐渐降低,但仍分别高于对照组的15-脂氧化酶相对表达量(0.26±0.12,P<0.05)和血液LXA4[(0.04±0.01)μg/L,P<0.05],患儿PEF与FEV1的减少与血液LXA4呈正相关.而轻、中、重度哮喘患儿白细胞5-脂氧化酶相对表达量分别为0.26±0.12、0.79±0.34和1.21±0.52(F=18.64,P<0.01),血液LTC4分别为(22.4±8.2)、(54.6±28.4)和(118.7±41.1)ng/L(F=25.91,P<0.01),逐渐升高,均分别高于对照组的5-脂氧化酶相对表达量(0.12±0.05)和血液LTC4[(6.8±2.5)ng/L,均P<0.05],PEF与FEV1的减少与血液LTC4呈负相关.结论 LXA4是白三烯的天然生理拮抗物质.哮喘患儿随着病情加重,体内15-脂氧化酶及其产物LXA4不足;5-脂氧化酶及其产物LTC4水平的升高,可能是哮喘加重的原因之一.
목적 료해불동정도지기관효천(간칭효천)환인백세포15-지양화매、5-지양화매、혈액지양소A4(lipoxin A4,LXA4)급백삼희C4(leukotriene C4,LTC4)수평적변화.방법 근거효천진단표준급분도표준선취효천환인106례작위효천조,검측전4주균무감염성질병혹기타장기질병;선취기왕건강적학교체검정상인동40명작위대조조.응용RT-PCR방법측정급성발작기적경、중、중도효천식인혈백세포15-지양화매、5-지양화매적mRNA표체,응용ELISA방법측정효천환인혈액LXA4、LTC4함량.관찰환인재흡입속효β2수체격동제후적호기봉류속(PEF)급FEV1여혈액LXA4급LTC4적관계.결과 경、중、중도효천식인백세포15-지양화매상대표체량분별위1.78±0.56、1.28±0.45화0.58±0.22(F=16.72,P<0.01),혈액LXA4분별위(5.52±1.97)、(1.86±0.72)화(0.81±0.36)μg/L(F=22.59,P<0.01),균축점강저,단잉분별고우대조조적15-지양화매상대표체량(0.26±0.12,P<0.05)화혈액LXA4[(0.04±0.01)μg/L,P<0.05],환인PEF여FEV1적감소여혈액LXA4정정상관.이경、중、중도효천환인백세포5-지양화매상대표체량분별위0.26±0.12、0.79±0.34화1.21±0.52(F=18.64,P<0.01),혈액LTC4분별위(22.4±8.2)、(54.6±28.4)화(118.7±41.1)ng/L(F=25.91,P<0.01),축점승고,균분별고우대조조적5-지양화매상대표체량(0.12±0.05)화혈액LTC4[(6.8±2.5)ng/L,균P<0.05],PEF여FEV1적감소여혈액LTC4정부상관.결론 LXA4시백삼희적천연생리길항물질.효천환인수착병정가중,체내15-지양화매급기산물LXA4불족;5-지양화매급기산물LTC4수평적승고,가능시효천가중적원인지일.
Objective To investigate the expressions of 15- and 5-lipoxygenases in leukocytes and the changes of the levels of blood lipoxin A4 (LXA4 ) and leukotriene C4 ( LTC4) in children with asthma. Methods The mRNA levels of 15- and 5-lipoxygenases in leukocytes were assessed by RT-PCR, and the levels of blood LXA4 and LTC4 were determined by ELISA, in 106 children with mild, moderate and severe asthma. Forty healthy children served as the controls. Results In children with mild, moderate and severe asthma, the relative mRNA levels of 15-lipoxygenase in leukocytes were 1.78 ±0.56, 1.28 ±0.45 and 0. 58 ±0. 22 (F = 16. 72, P <0. 01), respectively, and all were higher than that of the controls (0. 26 ± 0.12, P<0.05). The levels of blood LXA4 were (5.52±1.97), (1. 86 ±0.72) and (0. 81 ±0. 36) μg/L (F =22. 59, P <0.01), respectively, decreasing with the severity of asthma, and all were higher than that of the controls [ (0. 04 ±0. 01) μg/L, P <0. 05]. There was a positive correlation between PEF, FEV, and blood LXA4. The relative levels of 5-lipoxygenase mRNA in leukocytes were 0. 26 ±0. 12, 0. 79 ±0. 34 and 1. 21 ±0. 52,respectively in children with asthma of mild, moderate and severe degree(F = 18. 64, P <0. 01) ,which showed an increase with the severity of the disease, and all of which were higher than that of thecontrols (0.12 ±0.05, P< 0.05). The levels of blood LTC4 were (22.4 ± 8. 2 ), (54.6±28.4) and (118. 7 ±41. 1) ng/L ( F = 25. 91, P < 0.01), respectively, also showing an increase with the severity of asthma, and were higher than that of the controls [ (6. 8 ± 2. 5 ) ng/L, P < 0. 05 ]. There was a negative correlation between PEF, FEV, and blood LTC4. Conclusion The reversed changes of 15-lipoxygenase product LXA4 and 5-lipoxygenase product LTC4 in children with asthma of mild, moderate and severe degree suggests that insufficiency of LXA4, an physiological antagonist to leukotrienes, and an overproduction of LTC4 , may be involved in the pathogenesis of worsening of asthma in children.