摘要
目的探讨静脉注射丙种球蛋白(IVIG)治疗川崎病(KD)的作用机制。方法选择36例KD患儿及13例肺炎和上呼吸道感染患儿(对照组),应用Agilent基因表达谱芯片检测4例KD患儿(男3例、女1例)在IVIG治疗前后,以及1例3个月男性肺炎患儿外周血白细胞基因m RNA表达谱;其余32例KD和12例对照组患儿应用RT-PCR方法对表达差异基因进行验证分析。结果根据差异基因筛选标准(倍数≥2.0),发现KD患儿S100A12、S100A9、IL-1β、MMP9等基因IVIG治疗后表达水平比治疗前明显下调。经RT-PCR检测发现,IVIG治疗前组、IVIG治疗后组与对照组三组间IL-1β、S100A12、MMP9 m RNA表达的差异有统计学意义(P均<0.01)。与IVIG治疗前比较,KD患儿IL-1β和MMP9 m RNA表达在治疗后明显下调,差异有统计学意义(P均<0.01);KD患儿IL-1βm RNA表达水平在IVIG治疗前高于对照组,MMP9m RNA表达水平在IVIG治疗前、后均高于对照组,差异有统计学意义(P均<0.01)。4例KD合并冠状动脉损害(CAL)患儿及28例无合并CAL患儿在IVIG治疗前、后的MMP9和IL-1βm RNA表达水平差异有统计学意义(P均=0.001)。结论 IL-1β、S100A9、S100A12、MMP9等细胞因子在IVIG治疗KD中发挥了重要作用,其中MMP9基因的表达水平可能与KD合并CAL有关。
Objective To explore the mechanism of intravenous immunoglobulin （IVIG） treatment on Kawasaki disease （KD）. Methods Thirty-six KD patients and 13 patients with pneumonia or upper respiratory infection （control group） were se-lected. The gene expression proifles of peripheral white blood cells from 4 KD patients （three male, one female） pre-and post-IVIG therapy and one pneumonia patient （male） were analyzed by Agilent gene chip. The gene expression was detected in 32 KD patients and 12 control patients by real-time PCR. Results The expressions of IL-1β, S100A9, S100A12 and MMP9 were signiif-cantly down-regulated in response to IVIG. The expressions of IL-1β, S100A9, S100A12 and MMP9 mRNA were signiifcantly different among pre-treatment, post-treatment and control groups （P〈0.01）. The expressions of IL-1βand MMP9 mRNA were signiifcantly down-regulated in response to IVIG （P〈0.01）. The expression of IL-1βmRNA was signiifcantly higher in KD pa-tients than that in control group. The expression of MMP9 mRNA was signiifcantly higher in KD patients pre and post treatment than that in control group （P〈0.01）. The expression of MMP9 mRNA was signiifcantly higher in KD patients complicated with coronary artery lesion （CAL） than that in KD patients without CAL complication （P=0.001）. Conclusions The effects of IVIG on KD may be mediated by IL1B, S100A9, S100A12 and MMP9. MMP9 gene expression may be related to complication of CAL in KD.
出处
《临床儿科杂志》
CAS
CSCD
北大核心
2014年第12期1150-1154,共5页
Journal of Clinical Pediatrics
基金
上海市级医院适宜技术联合开发推广应用项目(No.SHDC12012238)
上海市科学技术委员会医学重点项目(No.10411954600)
