热休克蛋白60、70在川崎病冠状动脉病变中的表达及意义

Expression and significance of HSP60 and HSP70 in coronary artery disease of Kawasaki disease

目的:探讨热休克蛋白60(HSP60)、热休克蛋白70(HSP70)表达水平在川崎病(KD)冠状动脉病变进程中的作用,为KD诊治、监测及预防冠状动脉损害提供研究基础。方法:收集KD患儿30例作为KD组,按有无冠状动脉损害再分为冠状动脉损害组和非冠状动脉损害组。选择常规发热患儿30例作为阳性对照组。选择同期体检的健康儿童30例作为健康对照组。检测各组儿童血清中HSP60、HSP70的表达水平,并进行统计学分析。结果:KD病理Ⅰ期组患儿血清中HSP60、HSP70表达水平显著高于其他各组,差异均具有统计学意义(P<0.01)。KD病理Ⅱ-Ⅲ期组患儿血清HSP60表达水平与阳性对照组、健康对照组相比较,差异均无统计学意义(P>0.05)。KD病理Ⅱ-Ⅲ期组患儿血清HSP70表达水平显著高于阳性对照组、健康对照组,差异均具有统计学意义(P<0.05)。阳性对照组血清HSP60、HSP70表达水平和健康对照组比较,均无统计学差异(P>0.05)。KD患儿冠状动脉损害组血清HSP60表达水平明显高于非冠状动脉损害组,但血清HSP70表达水平明显低于非冠状动脉损害组,差异均有统计学意义(P<0.01)。结论:KD病理Ⅰ期组血清HSP60、HSP70水平的高表达提示其在KD病理Ⅰ期中均积极地参与了血管炎性反应,HSP60起到促进血管炎性反应作用,而HSP70起了相反作用;KD病理Ⅱ-Ⅲ期组血清HSP70的表达仍持续在较高水平,提示HSP70对血管炎性反应的抑制作用可以维持到病程的病理Ⅱ-Ⅲ期。KD血清中HSP60、HSP70水平的监测可以反映该疾病的转归及其进展,为治疗川崎病、预防及减轻冠脉病变提供理论依据。

Objective:To explore the role of heat shock protein 60(HSP60)and heat shock protein 70(HSP70)expression levels in the progression of coronary artery disease in Kawasaki disease(KD),so as to provide a research basis for the diagnosis,treatment,monitoring and prevention of coronary artery disease in KD.Methods:A total of 30 children with KD were collected as KD group.According to the presence or absence of coronary artery damage,they were further divided into coronary artery lesion group and non-coronary artery lesion group.30 cases of children with routine fever were selected as positive control group,and 30 cases of healthy children who underwent medical examination during the same period were selected as healthy control group.The expression levels of HSP60 and HSP70 in the serum of children in each group were detected and statistically analyzed.Results:The expression levels of HSP60 and HSP70 in the serum of children with KD pathology stageⅠgroup were significantly higher than those of other groups,and the differences were statistically significant(P<0.01).Compared with the positive control group and healthy control group,the serum HSP60 expression level in the KD pathology stageⅡ-Ⅲgroup was not statistically significant(P>0.05).The serum HSP70 expression level of children in the KD pathology stageⅡ-Ⅲgroup was significantly higher than that of the positive control group and healthy control group,and the difference was statistically significant(P<0.05).Compared with the healthy control group,the expression levels of serum HSP60 and HSP70 in the positive control group were not statistically significant(P>0.05).The serum HSP60 expression level in the coronary artery lesion group was significantly higher than that in the non-coronary artery lesion group,and the difference was statistically significant(P<0.01).Conclusion:The high expression levels of serum HSP60 and HSP70 in the KD pathology stageⅠgroup suggests that they actively participated in the vascular inflammatory response in the KD pathology stageⅠ.HSP60 plays a role in promoting vascular inflammatory response,while HSP70 plays the opposite role.The expression of serum HSP70 in the KD pathology stageⅡ-Ⅲgroup is still at a relatively high level,which suggests that the inhibitory effect of HSP70 on the vascular inflammatory response can be maintained until the pathological stageⅡ-Ⅲ.The monitoring of HSP60 and HSP70 levels in KD serum can reflect the prognosis and progress of the disease,and provide a theoretical basis for the treatment of Kawasaki disease,prevention and reduction of coronary artery disease.