川崎病患儿急性期外周血单个核细胞NLRP3炎症小体的表达及其临床意义

Expression of Nod-like receptor protein 3 inflammasome in peripheral blood mononuclear cells of children with Kawasaki disease in the acute stage

目的探讨Nod样受体蛋白3(NLRP3)炎症小体与川崎病(KD)患儿急性期炎症反应以及冠状动脉损伤的关系。方法前瞻性纳入2017年1~10月住院的KD患儿42例为研究对象,其中伴冠状动脉损伤(CAL)9例,非冠状动脉损伤(NCAL)33例。另外选取性别、年龄相匹配的15例肺炎发热患儿作为发热对照组,15例健康儿童作为健康对照组。采用实时荧光定量PCR检测外周血单个核细胞NLPR3炎症小体(NLRP3、ASC和caspase-1)mRNA的表达。采用Spearman秩相关分析法评估NLRP3 mRNA表达与血清C反应蛋白(CRP)、红细胞沉降率(ESR)、白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)、降钙素原、白蛋白及前白蛋白水平的相关性。结果 KD组急性期外周血NLRP3、ASC和caspase-1 mRNA表达明显高于发热对照组及健康对照组(P < 0.05);CAL组患儿NLRP3 mRNA表达明显高于NCAL组(P < 0.05)。KD患儿急性期NLRP3 mRNA表达与CRP、IL-6、IL-1β、前白蛋白水平存在相关性(rs分别为0.449、0.376、0.427、-0.416,均P < 0.05)。结论 NLRP3炎症小体可能参与了KD急性期炎症反应及CAL的发生。

Objective To study the association of Nod-like receptor protein 3 (NLRP3) inflammasome with inflammatory response in the acute stage and coronary artery lesion (CAL) in children with Kawasaki disease (KD).Methods A total of 42 children with KD who were hospitalized from January to October 2017 were enrolled as the KD group, among whom 9 had CAL (CAL group) and 33 had no CAL (NCAL group). Fifteen age-and gendermatched children with pneumonia and pyrexia were enrolled as the pneumonia-pyrexia group. Fifteen healthy children were enrolled as the healthy control group. Real-time PCR was used to measure the mRNA expression of NLRP3 inflammasome (NLRP3, ASC and caspase-1) in peripheral blood mononuclear cells. The Spearman rank correlation test was used to investigate the correlation of NLRP3 mRNA expression with serum levels of C-reactive protein, erythrocyte sedimentation rate, interleukin-6, interleukin-1β, procalcitonin, albumin and prealbumin.Results The KD group had significantly higher mRNA expression of NLRP3, ASC and caspase-1 in the acute stage than the pneumonia-pyrexia and healthy control groups (P < 0.05). The CAL group had significantly higher mRNA expression of NLRP3 than the NCAL group (P < 0.05). NLRP3 mRNA expression was correlated with C-reactive protein, interleukin-6, interleukin-1β, and prealbumin levels in children with KD in the acute stage (rs=0.449, 0.376, 0.427, and -0.416 respectively;P < 0.05).Conclusions NLRP3 inflammasome may participate in inflammatory response in the acute stage and the development of CAL in children with KD.