川崎病急性期冠状动脉损害诱导型一氧化氮合酶变化及其意义研究

Expression and role of inducible nitric oxide synthase in acute phase of Kawasaki disease with coronary artery lesions

目的观察川崎病(KD)急性期诱导型一氧化氮合酶(iNOS)水平变化,探讨其在KD冠状动脉(简称冠脉)损害中的作用。方法2006年3月至2006年12月浙江省温州医学院附属儿童医院住院的典型KD患儿30例(冠脉无扩张15例,冠脉扩张15例),另选年龄匹配的15名正常儿童为对照组。脐静脉内皮细胞培养分为正常血清组(C组)、KD冠脉正常组(NAC组)、KD冠脉损害组(AC组)。分别测定各组血清作用后的人脐静脉内皮细胞培养上清液中一氧化氮(NO)和iNOS水平;同时收集细胞,采用逆转录聚合酶链式反应(RT-PCR)检测iNOS mRNA表达。结果KD患儿血清刺激后,细胞上清液NO和iNOS水平明显升高,与C组相比,差异有统计学意义(P均<0.05),且AC组更为明显;培养细胞iNOS mRNA表达明显高于C组(P<0.05),AC组升高最为明显(P<0.05)。结论iNOS在有冠脉损害的KD急性期表达明显升高,iNOS的过度表达可能参与了KD冠脉损害的发生发展。

Objective To investigate the potential role of inducible nitric oxide synthase （iNOS） in the pathogenesis of coronary artery lesions in patients with Kawasaki disease （KD）. Methods Thirty patients with KD, including 15 patients who had no coronary artery lesions and 15 patients who had coronary artery lesions, as well as age-matched afebrile controls patients （n = 15） were studied. HUVEC were cultured in 3 different conditional media with normal serum group（C group）, KD without Coronary artery lesion serum group（NAC group） and KD with coronary artery lesion serum group （AC group）. Chemical colorimetry was used to detect the enzyme activity of NO and iNOS in superuatant . iNOS mRNA expression in HUVEC cells was studied by RT-PCR. Results The activity of NO and iNOS in superuatant in HUVEC cultured with 10 % serum from KD patients was all significantly elevated （ P 〈 0. 05） , compared with C group , especially AC group. The expression of iNOS mRNA in HUVEC was significantly elevated, compared with the afebrile controls（P 〈 0.05）. Moreover, the expression of iNOS mRNA in HUVEC from the acute KD with coronary artery lesions was signficantly higer than those in KD without coronary artery lesions （P 〈 0.05）. Conclusion Over-expressions of iNOS in acute KD may be involved in the formation of coronary artery lesions and pathogenesis of KD.