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目的探讨BLyS/April在川崎病(KD)免疫发病机制中的作用。方法急性期KD患儿48例,正常同年龄对照组32名,KD患儿分别于静脉注射丙种球蛋白(IVIG)治疗前后直接取血备检。采用反转录-聚合酶链反应(RT-PCR)及荧光定量PCR检测单核-巨噬细胞(MC)BLyS和April,BLyS/April受体BR3、BCMA、TACI及细胞因子mRNA表达;双抗体夹心酶联免疫吸附试验(ELISA)检测血浆中细胞因子蛋白浓度。结果①急性期KD患儿MC BLyS和April mRNA表达明显高于正常同年龄对照组(P<0.01),经IVIG治疗后表达不同程度下降;②BLvS/April受体BR3、BCMA和TACI基因转录水平显著高于正常同年龄对照组(P<0.01);③急性期KD患儿抗体类型转换相关细胞因子白细胞介素(IL)-4、IL-5、IL-6、IL-10、IL-15 mRNA表达水平及蛋白浓度明显高于正常同年龄对照组(P<0.01);④KD患儿BLyS/April调控因子干扰素(IFN)-α/γ、IL-10 mRNA表达水平及血浆浓度明显高于正常同年龄对照组(P<0.01)。结论急性期KD患儿BLyS/April过表达可能是导致KD免疫功能紊乱的因素之一。
Objective To investigate the role of BLyS / April in the pathogenesis of KD. Methods 48 cases of acute KD children, 32 cases of normal control group, KD children were intravenously administered intravenous gamma globulin (IVIG) before and after treatment for blood test. The expression of BLyS, April, BLyS / April receptors BR3, BCMA, TACI and cytokines were detected by reverse transcription polymerase chain reaction (RT-PCR) and real- Sandwich enzyme-linked immunosorbent assay (ELISA) was used to detect plasma concentrations of cytokines. Results ① The expression of MC BLyS and April mRNA in children with KD in acute stage were significantly higher than those in normal control group (P <0.01), and the expression of MC BLyS and April mRNA were decreased to some extent after treatment with IVIG. ② The transcriptional levels of BR3, BCMA and TACI gene in BLvS / (P <0.01). ③The levels of IL-4, IL-5, IL-6, IL-10 and IL-15 mRNA in the KD children with acute phase were significantly higher than those in the control group (P <0.01). (4) The levels of BLyS / April regulatory factor interferon (IFN) -α / γ, IL-10 mRNA and plasma concentrations in children with KD were significantly higher than those in normal controls The same age control group (P <0.01). Conclusion The overexpression of BLyS / April in children with acute KD may be one of the factors leading to the disorder of KD immunity.