CAJ | 학술논문

目的观察静脉注射免疫球蛋白(intravenous immunoglobulin,IVIG)治疗川崎病(Kawasaki disease,KD)对血浆前列腺素E2(prostaglandin E2,PGE2)水平的影响.方法选取2012年2月-2012年8月在我院住院治疗的25例KD患儿为研究对象,分别在IVIG前后使用双抗体夹心酶联免疫吸附试验(ELISA)测定血浆PGE2、环氧化酶-2(cyclooxygenases-2,cOX-2)、血红素氧化酶-1(hemeoxygenase-1,HO-1)、红系衍生核因子相关因子-2(nuclear factor-erythroid 2-related factor-2,Nrf2)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平,采用逆转录-聚合酶链反应(RT-PCR)及实时荧光定量PCR法测定外周血CD14+单核/巨噬细胞(monocyte/macrophage cells,MC)、COX-2、HO-1、Nrf2、白细胞介素-6(interleukin-6,IL-6)、TNF-α水平.选取15例同龄健康儿童为对照组,测定以上指标.结果急性期KD患儿PGE2、COX-2、IL-6、TNF-α水平较对照组明显升高(P＜0.05),HO-1、Nrf2水平明显降低(P＜0.05);IVIG治疗后PGE2、COX-2、IL-6、TNF-α水平较治疗前显著下降(P＜0.05),HO-1、Nrf2水平较治疗前显著上升(P＜0.05).结论 IVIG影响KD患儿PGE2的表达.PGE2在KD的免疫和炎症反应及氧化应激中具有重要的作用,COX-2/HO-1/Nrf2-ARE信号通路可能是其调控通路之一.
목적 관찰정맥주사면역구단백(intravenous immunoglobulin,IVIG)치료천기병(Kawasaki disease,KD)대혈장전렬선소E2(prostaglandin E2,PGE2)수평적영향.방법 선취2012년2월-2012년8월재아원주원치료적25례KD환인위연구대상,분별재IVIG전후사용쌍항체협심매련면역흡부시험(ELISA)측정혈장PGE2、배양화매-2(cyclooxygenases-2,cOX-2)、혈홍소양화매-1(hemeoxygenase-1,HO-1)、홍계연생핵인자상관인자-2(nuclear factor-erythroid 2-related factor-2,Nrf2)、종류배사인자-α(tumor necrosis factor-α,TNF-α)수평,채용역전록-취합매련반응(RT-PCR)급실시형광정량PCR법측정외주혈CD14+단핵/거서세포(monocyte/macrophage cells,MC)、COX-2、HO-1、Nrf2、백세포개소-6(interleukin-6,IL-6)、TNF-α수평.선취15례동령건강인동위대조조,측정이상지표.결과 급성기KD환인PGE2、COX-2、IL-6、TNF-α수평교대조조명현승고(P＜0.05),HO-1、Nrf2수평명현강저(P＜0.05);IVIG치료후PGE2、COX-2、IL-6、TNF-α수평교치료전현저하강(P＜0.05),HO-1、Nrf2수평교치료전현저상승(P＜0.05).결론 IVIG영향KD환인PGE2적표체.PGE2재KD적면역화염증반응급양화응격중구유중요적작용,COX-2/HO-1/Nrf2-ARE신호통로가능시기조공통로지일.
Objective To investigate the effects of intravenous immunoglobulin (IVIG) on the concentration of prostaglandin E2 (PGE2) in plasma of patients with Kawasaki disease (KD).Methods Twenty-five hospitalized patients with KD in Shenzhen Children's Hospital from February to August 2012 were enrolled in the study.Fifteen healthy children at the same age were selected as the control group.The concentrations of PGE2,cyclooxygenases-2 (COX-2),hemeoxygenase-1 (HO-1),nuclear factor-erythroid 2-related factor-2 (Nrf2) and tumor necrosis factor-α (TNF-α) in plasma were analyzed by sandwich enzyme-linked immunosorbent assay(ELISA) before and after IVIG treatment.The reverse transcription-polymerase chain reaction (RT-PCR) and real-time quantitative PCR were used to evaluate the expressions of COX-2,HO-1,Nrf2,interleukin-6 (IL-6) and TNF-α in peripheral blood CD14+ monocyte/macrophage cells (MCs) before and after IVIG treatment.Results The expressions of PGE2,COX-2,IL-6 and TNF-α in patients with acute KD were higher than those in the control group (P＜0.05),but the expressions of HO-1 and Nrf2 were lower than those in the control group(P＜0.05).After the IVIG treatment,the expressions of PGE2,COX-2,IL-6 and TNF-α were significantly down-regulated (P ＜ 0.05) whereas the expressions of HO-1 and Nrf2 were significantly up-regulated (P＜0.05) in patients with acute KD.Conclusion PGE2 plays an important role in immune status,inflammatory response and oxidative stress of KD patients.The IVIG treatment might regulate PGE2 expression in patients with KD through regulating COX-2/HO-1/Nrf2-ARE signaling pathway.