静脉注射免疫球蛋白治疗川崎病机理:对细胞凋亡的探讨

Study on the mechanism of intravenous immunoglobulin in treating Kawasaki disease

目的:本文通过观察静脉注射免疫球蛋白(IVIG)对,急性期川崎病(KD)患儿外周血淋巴细胞凋亡的影响,进一步探讨IVIG的治疗机理.方法:本组观察了26例KD患儿和20例健康对照外周血单个核细胞(PHMC)经anti-CD_3单抗刺激培养不同时间后计数凋亡细胞百分率和DNA片断分析,及PHA诱导的淋巴细胞增殖反应及IL-6水平.结果:KD患儿 PBMC体外培养上清波IL-6水平较对照明显升高(P<0.001),IVIG治疗后,KD患儿PBNC产生IL-6水平明显降低,外用血淋巴细胞凋亡细胞百分率提高,片断 DNA出现时间提前,与治疗前比较差异显著(P<0.05).同时与单用阿司匹林(ASP)组比较,临床症状改善,淋巴细胞增殖活性降低(P<0.001).结论:IVIG治疗 KD的机理可能部分归于逆转被抑制的淋巴细胞凋亡.本组研究为IVIG治疗免疫性疾病提供了新的理论基础.

ve: To further explore the therapeutic mechanism of IVIG for immune - mediated disease. Methods PBMC: from 26 children with KD and 20 age-matched health Children were stimulated by anti-CD3 monoclonal antibody , apoptotic cell percentage and DNA fragmentation were assayed in vitro. PBMC were stimulated by phytohemagglutinin (PHA)to evaluate lymphocyte proliferative response and to measure the IL-6 level in the supernatant. Results: After IVIG treatment, the decreased apoptotic cell percentage and delayed DNA fragmentation in KD patieants were reversed to those of normal controls. The clinical remission was faster than those of patients treated with aspirin alone. Lymphoproliferative reponse was also down - regulated in vitro after IVIG therpay (P< 0. 05). Conclusion: The therapeutic mechanism of IVIG for KD may be partially contributed to reverse the inhibited lymphocyte apoptosis, which provide new theory basis for treating immue - mediated disease.