儿童川崎病并发EB病毒感染NF-κB信号通路表达及其影响

Expression of NF-κB signaling pathway in children with Kawasaki disease EB virus infection and its effect

目的 探究儿童川崎病(KD)并发EB病毒(EBV)感染核因子κB(NF-κB)信号通路表达及其对细胞炎症因子释放和冠脉损伤(CAL)的影响。方法 选取2017年12月—2020年12月抚州市第一人民医院儿科收治的KD患儿89例,根据EBV DNA检测结果分为EBV感染组30例和无EBV感染组59例,采用酶联免疫吸附法检测患儿血清炎症因子[白细胞介素(IL)-6、IL-8、IL-10、IL-1β、肿瘤坏死因子α(TNF-α)]、基质金属蛋白酶(MMP)-2、MMP-9及其特异性组织抑制剂1(TIMP-1)、NF-κB及其抑制蛋白(IκBα)表达,实时荧光定量聚合酶链式反应法(PCR)检测NF-κB、IκB mRNA水平,统计两组患儿CAL发生率。结果 EBV感染组患儿外周血白细胞计数、血清IL-6、IL-8、IL-10、IL-1β、TNF-α、MMP-2、MMP-9、NF-κB及其mRNA水平高于无EBV感染组,TIMP-1、IκBα及其mRNA水平均低于无EBV感染组(P<0.05);EBV感染组CAL发生率为43.33%(13/30),高于无EBV感染组(P<0.05)。结论 合并EBV感染的川崎病患儿外周血炎症细胞因子水平上调,CAL发生率明显升高,EBV感染可能通过激活NF-κB信号通路介导炎症反应造成CAL。

OBJECTIVE To investigate the expression of nuclear factor-κB(NF-κB) signaling pathway in children with Kawasaki disease(KD) epstein-Barr virus(EBV) infection and its effect on the release of inflammatory cytokines and coronary artery lesion(CAL). METHODS A total of 89 children with KD admitted to Pediatrics Department of Fuzhou First People′s Hospital from Dec 2017 to Dec 2020 were selected and divided into 30 cases of EBV infection group and 59 cases of non-EBV infection group according to the results of EBV DNA testing. The expression levels of serum inflammatory factors [interleukin(IL-6, IL-8, IL-10, IL-1β), tumor necrosis factor α(TNF-α)], matrix metalloproteinase(MMP-2, MMP-9) and its tissue inhibitor of metalloproteinase-1(TIMP-1), NF-κB and its profilin(IκBα) were detected by enzyme-linked immunosorbent assay(ELISA). The levels of NF-κB and IκB mRNA were detected by real-time fluorescent quantitative polymerase chain reaction(PCR). The incidence of CAL in both groups was calculated. RESULTS The levels of peripheral blood white blood cell count, serum IL-6, IL-8, IL-10, IL-1β, TNF-α, MMP-2, MMP-9, NF-κB and its mRNA in the EBV infection group were significantly higher than those in non-EBV infection group, while levels of TIMP-1, IκBα and its mRNA were significantly lower than those in non-EBV infection group(P<0.05). The incidence of CAL in EBV infection group was 43.33%(13/30), significantly higher than that in non-EBV infection group(P<0.05). CONCLUSION The levels of inflammatory cytokines in peripheral blood of children with KD combined with EBV infection were up-regulated, and incidence of CAL was significantly increased. EBV infection may mediate inflammation response by activating NF-κB signaling pathway and cause CAL.