共刺激分子4-1BB在川崎病患儿外周血单个核细胞的表达及意义

Expression and Significance of Costimulatory Molecules 4-1BB on Peripheral Blood Mononuclear Cells of Children with Kawasaki Disease

目的：探讨川崎病（KD）患儿不同时间点外周血单个核细胞（PBMC）共刺激分子4-1BB的表达及意义。方法：选择30例KD住院患儿为研究对象,30名健康体检儿童作为对照组。KD患儿分2个时间点采集外周血标本：（1）发病初未用丙种球蛋白（IVIG）时,患儿体温39℃~40℃,呈稽留或弛张热型（急性期）;（2）足量IVIG治疗后体温正常1周以上（缓解期）。采用反转录-聚合酶链式反应（RT-PCR）法检测KD患儿不同时间点PBMC共刺激分子4-1BB mRNA的表达,并分析其与血清C反应蛋白（CRP）的关系。结果：（1）对照组儿童和KD患儿PBMC均有4-1BB mRNA的表达。（2）急性期KD患儿PBMC 4-1BB mRNA的表达水平明显升高,与对照组及缓解期KD患儿比较差异均有统计学意义（P均〈0.05）;缓解期KD患儿与对照组比较差异有统计学意义（P〈0.05）。（3）KD患儿4-1BB mRNA的表达水平与血清CRP呈正相关（r=0.723,P〈0.05）。结论：共刺激分子4-1BB可能参与了KD的发病,可作为监测病情的免疫学指标。

Objective： To investigate the expression and significance of costimulatory molecules 4-1BB on peripheral blood mononuclear cell （PBMC） of children with Kawasaki disease （KD） at different time point. Methods： Reverse transcription-polymerase chain reaction （RT-PCR） was applied to detect the expression of costimulatory molecules 4-1BB mRNA on PBMC in 30 KD children （KD group） at different time point （acute stage： before IVIG treatment, children have a temperature of 39 ℃ ~ 40℃; remission stage： norrnothermia one week after IVIG treatment） , and 30 healthy children served as a control group. Results： （ 1 ） Both the control and KD group were detected the expression of 4-1BB mRNA. （2） In acute stage of KD group, the expression of 4-1BB mRNA was significantly higher than those in remission stage of KD group and control group （P〈0.05） ; In remission stage of KD group, the expression of 4-1BB mRNA was significantly higher than that in control group （P〈0.05）. （3） A positive correlation was found between expression of 4-1BB mRNA and CRP （r = 0. 723, P〈0. 05）. Conclusion： The costimulatory molecules 4-1BB may play a pathological role in the development of KD. It may be utilized as a monitoring of immunological marker.