过敏性紫癜患儿血清可溶性血管细胞黏附分子-1及可溶性细胞间黏附分子-1表达的意义

目的 检测过敏性紫癜(HSP)患儿血清可溶性血管细胞黏附分子-1(sVCAM-1)及可溶性细胞间黏附分子-1(sICAM-1)表达,并探讨其临床意义.方法 酶联免疫吸附法(ELISA)测定53例HSP患儿(其中急性期37例,恢复期16例)及25例健康儿童血清sVCAM-1、sICAM-1水平,分别比较其急性期和恢复期及有或无肾损害HSP患儿上述因子表达水平.结果 HSP急性期患儿血清sVCAM-1和sICAM-1水平明显高于恢复期和健康对照组(Pa＜0.01);肾损害组血清sVCAM-1、sICAM-1明显高于无肾损害组(Pa＜0.01).结论 sVCAM-1、sICAM-1参与HSP病理生理过程,与疾病分期相关;血清sVCAM-1、sICAM-1水平增高可作为儿童HSP肾损害的判断指标之一.     

过敏性紫癜患儿血浆血管内皮生长因子和可溶性血管细胞黏附分子-1的表达

目的探讨血管内皮生长因子（VEGF）和可溶性血管细胞黏附分子-（sVCAM-1）在过敏性紫癜（HSP）儿童表达的意义。方法HSP患儿58例。其中急性期30例,缓解期28例。正常对照组23例。采用固相酶联免疫吸附法（ELISA）分别检测其血浆VEGF、sVCAM-1水平,并进行两两比较和相关分析。结果HSP急性期患儿血浆VEGF、sVCAM-1水平明显高于缓解期和对照组（Pa〈0.01）,且二者呈正相关（r=0.939P〈0.001）。结论VEGF、sVCAM-1可能参与HSP发病过程,对病情发展及预后判断有一定意义。     

过敏性紫癜患儿血清与尿液中粘附分子sICAM-1 sVCAM-1水平变化的研究

目的了解过敏性紫癜(HSP)患儿血清和尿液中可溶性细胞间粘附分子-1(sICAM-1)、可溶性血管细胞粘附分子-1(sVCAM-1)的水平。探讨粘附分子在HSP发病机制中的作用。方法研究对象为2006年3月至2006年11月在首都儿科研究所附属儿童医院住院的40例HSP患儿,正常对照为同期的33例外科非感染性疾病患儿,检测其外周血及尿液中粘附分子sICAM-1、sVCAM-1的水平。结果(1)HSP组血清sICAM-1、sV-CAM-1水平显著高于对照组(P<0.05)。但在肾炎组与非肾炎组中差异无统计学意义(P=0.659,0.080)。(2)HSP组尿液中sICAM-1、sVCAM-1水平与对照组差异无统计学意义(P=0.479,0.164)。HSP患儿肾炎组尿液中sICAM-1、sVCAM-1水平分别高于非肾炎组和正常对照组,但差异均无统计学意义(P>0.05)。而肾炎组中病理分级较重患儿其尿中两种粘附分子水平均较高。结论HSP患儿血清sICAM-1、sVCAM-1水平升高,尿sI-CAM-1、sVCAM-1水平可能与HSP患儿肾脏病变程度有关。粘附分子的表达增加参与了HSP发病的病生理过程。     

过敏性紫癜患儿血清白细胞介素-10、白细胞介素-13、白细胞介素-15与C反应蛋白水平变化的意义

目的 分析过敏性紫癜(HSP)患儿急性期与缓解期血清IL-10、IL-13、IL-15、CRP水平变化及各项指标间的相关性,探讨其临床意义.方法 选择2010年9月-2011年5月确诊为HSP的住院患儿40例作为HSP急性期组研究对象,40例患儿经正规治疗2周左右,在皮疹、腹痛、关节肿胀疼痛症状消失后作为缓解期组研究对象.采用EHSA双抗体夹心法检测HSP患儿急性期与缓解期血清IL-10、IL-13、IL-15水平,采用免疫速率散射比浊法检测CRP水平.选取门诊同期体检健康儿童20例作为健康对照组.应用SPSS17.0软件对数据进行统计学分析.结果 1.HSP患儿急性期血清IL-10、IL-13、IL-15和CRP的水平明显高于缓解期组和健康对照组(P＜0.01或＜0.05);缓解期组血清仅IL-13水平显著高于健康对照组(P＜0.05),而IL-10、IL-15及CRP的水平与健康对照组比较差异均无统计学意义(Pa＞0.05);2.HSP患儿急性期血清IL-10、IL-13、IL-15和CRP各项指标间均存在显著相关性.结论 HSP患儿存在IL-10、1L-13、IL-15及CRP的分泌紊乱,其参与了HSP的发病过程.其中IL-10和IL-13可能起到一定保护作用.     

过敏性紫癜患儿血清sVCAM-1与PDGF的表达及临床意义

目的 探讨人可溶性血管黏附因子1(soluble vasccular cell adhension molecule-1,sVCAM-1),人血小板源生长因子(platelet-derived growth factor,PDGF)在过敏性紫癜(Henoch-Sc(o)nlein purpura,HSP)中的变化及其临床意义.方法 用酶联免疫吸附法(ELISA)检测41例HSP患儿和20名健康儿血清sVCAM-1、PDGF含量.结果 急性期和恢复期HSP患儿血清sVCAM-1和PDGF含量均高于对照组(P均<0.05),HSP急性期与恢复期对比差异具有统计学意义.恢复期血sVCAM-1和PDGF含量在均数以上者半年后随访肾损害发生率较在均数以下者高.结论 HSP患儿血清sVCAM-1、PDGF含量明显升高.提示上述两项指标均参与了HSP的发病过程,且对判断病情及预后有重要临床意义.     

过敏性紫癜血清抗内皮细胞抗体检测及其临床意义

目的检测过敏性紫癜患儿血清抗内皮细胞抗体(AECA)水平,探讨其在HSP发病机制中的作用。方法 2010年6月至2011年1月在温州医学院附属育英儿童医院肾脏科住院的过敏性紫癜患儿(HSP)60例,分为紫癜性肾炎(HSPN)组40例和非HSPN组20例,按病程分为急性期和缓解期,另以20名健康儿童作为对照组。应用酶联免疫吸附法(ELISA)检测血清AECA水平。结果对照组血清AECA为(232.31±53.89)ng/mL。HSP患儿急性期为(355.18±58.07)ng/mL,与对照组比较,差异有统计学意义(P<0.01);缓解期为(243.19±58.68)ng/mL,与对照组比较,差异无统计学意义(P>0.05),与急性期比较,差异有统计学意义(P<0.01)。非HSPN组急性期为(328.09±57.97)ng/mL,HSPN组为(369.66±59.20)ng/mL,差异有统计学意义(P<0.05)。结论 AECA可能参与了HSP血管损伤的病理过程,检测AECA可作为判断HSP病情的指标。     

过敏性紫癜患儿血浆白三烯B4、血栓调节蛋白和P-选择素的表达

目的 研究白三烯B4(leukotriene B4,LTB4)、血栓调节蛋白(thronmbomodulin,TM)和P-选择素在儿童过敏性紫癜(Henoch-Schnlein purpura,HSP)发病机制中的作用.方法 采用ELISA 法检测55例HSP患儿血浆LTB4、TM 和P-选择素水平,并与15例健康儿童进行比较.结果 过敏性紫癜患儿血浆LTB4、TM和P-选择素水平均明显高于对照组(P ＜ 0.01);合并肾脏损害的HSP患儿血浆LTB4、TM 水平明显高于单纯HSP患儿(P ＜ 0.01);血浆P-选择素水平的差异无统计学意义(P ＞ 0.05);HSP患儿血浆LTB4与TM水平呈正相关(r ＝ 0.745,P ＜ 0.05),血浆TM与P-选择素呈正相关(r ＝ 0.593,P ＜ 0.05).结论 血管内皮损伤和血小板活化在HSP的发病机制中起重要作用,LTB4、TM水平测定有助于了解病情轻重及是否合并肾脏损害.     

血浆可溶性P-选择素与儿童偏头痛关系的研究

目的 研究血浆可溶性P-选择素水平与儿童偏头痛的关系.方法 采用ABC-ELISA法检测偏头痛组、偏头痛病情控制组及健康对照组儿童可溶性P-选择素的水平、经颅多普勒(TCD)和外周血血小板计数,并进行P-选择素与血小板计数的相关性分析.结果 偏头痛组患儿血浆可溶性P-选择素水平明显高于病情控制组及健康对照组,差异有统计学意义(F=111.067,P<0.05);病情控制组与正常对照组比较,差异元统计学意义(P>0.05);TCD检测显示偏头痛组患儿脑血管痉挛发生率明显高于病情控制组患儿,差异有统计学意义(X2=23.08,P<0.05);血常规检查显示偏头痛组血小板计数高于病情控制组及健康对照组,差异有统计学意义(X2=22.22,P<0.05);病情控制组患儿血浆可溶性P-选择素水平降至正常,脑血管痉挛及血小板数升高的发生率均降至正常水平.血浆可溶性P-选择素水平与血小板计数呈正相关(r=0.996,P<0.01).结论 儿童偏头痛血浆可溶性P-选择素增高,脑血管痉挛发生率明显增高.血浆可溶性P-选择素与血小板计数呈正相关.血浆可溶性P-选择素可作为儿童偏头痛诊断、治疗及疗效评价的指标之一.     

紫癜性肾炎患儿血浆肿瘤坏死因子-α、转化生长因子-β1水平变化及相关性研究

目的探讨紫癜性肾炎（HSPN）患儿血浆TNF-α和转化生长因子-β 1（TGF-β1）水平的变化及其相关性,探讨其在过敏性紫癜（HSP）肾损害中的作用。 方法对30例HSP患儿、38例HSPN患儿和30例健康对照组儿童采用ELISA法测定其 血浆TNF-α、TGF-β1水平。尿分析仪测定其24h尿蛋白定量。HSPN患儿中32例 行肾活检,进行光镜、免疫荧光及电镜检查。采用SPSS11.0软件进行统计学分析 。结果1.HSP无肾损害组血浆TNF-α、TGF-β1水平高于健康对照组,有统计学差 异（Pa〈0.01）;HSPN组亦高于健康对照组,有统计学差异（Pa〈0.01）;HSPN组高于 HSP无肾损害组,有统计学差异（Pa〈0.01）。2.HSP病例组血浆TNF-α与TGF-β1水 平呈正相关（r=0.819P〈0.01）;HSPN组临床表现为肾病综合征者血浆TNF-α、 TGF-β1与24h尿蛋白定量呈正相关（r=0.809,0.860Pa〈0.01）。3.HSPN组血浆 TNF-α、TGF-β1与病理分级呈正相关（r=0.859,0.943Pa〈0.01）。结论血浆TNF- α、TGF-β1相互作用参与HSPN的发病及迁延进展,且与临床肾脏病变程度密切相 关,检测HSPN患儿血浆TNF-α、TNF-β1水平对于估计HSPN的预后具有一定的参 考价值。     

过敏性紫癜患儿血浆血栓调节蛋白血管性假血友病因子基质金属蛋白酶-9的检测及临床意义

目的检测过敏性紫癜(HSP)患儿血浆血栓调节蛋白(TM)、血管性假血友病因子(vWF)、基质金属蛋白酶-9(MMP-9)水平,探讨它们在HSP发病机制中的作用及与紫癜性肾炎(HSPN)的关系。方法2006-09—2007-02在青岛大学医学院附属烟台毓璜顶医院儿内科住院的HSP患儿46例,应用酶联免疫吸附试验(ELISA)检测HSP患儿急性期(46例)、缓解期(40例)及健康对照儿童(20例)血浆TM、vWF、MMP-9水平。结果HSP患儿急性期TM、vWF、MMP-9水平明显高于对照组(P均<0.01),也高于缓解组(P均<0.05)。MMP-9下降较缓慢,在恢复期仍显著高于对照组(P=0.01)。伴肾受累组vWF、MMP-9高于非肾受累组(P均<0.05),而TM在两组之间差异无显著性意义(P>0.05)。TM、vWF浓度之间成直线正相关,而TM、vWF分别与MMP-9之间相关性分析无统计学意义。结论血管内皮细胞及细胞外基质损伤在HSP的发病机制中起着重要的作用,血浆TM、vWF、MMP-9水平测定有助于了解病情活动及判断是否合并肾脏损害,动态测定有助于观察病情演变及指导治疗。     

Association of serum-soluble CD26 and CD30 levels with asthma, lung function and bronchial hyper-responsiveness at school age

Aim: There is a need for markers of Th1 and Th2 imbalance in diseases such as asthma. CD30 is an activation marker of Th2 cells, and importance of Th1 marker CD26 was recently found in adult asthma. We studied whether serum‐soluble CD30 (sCD30) or serum‐soluble CD26 (sCD26) could support early diagnosis of asthma in children at school age. Methods: sCD26 and sCD30 were measured in 34 children with clinically confirmed asthma, 31 with possible asthma and in 147 controls. In addition, the associations of flow volume spirometry, methacholine inhalation challenge and free running test results with serum sCD26 or sCD30 were analysed. Results: Serum sCD30 was significantly higher in children with confirmed asthma (mean 91.5 IU/mL, SD 23.0) than in the controls (78.8 IU/mL, 25.9; p = 0.042). No significant differences were found in serum sCD26 levels between the groups. There was a negative correlation of mean mid expiratory flow values with serum sCD26 (r = ?0.22, p = 0.0018). Neither methacholine inhalation challenge nor free running test results were associated with serum sCD26 or sCD30. Conclusion: Serum sCD30 was higher in children with asthma. However, marked overlap in serum sCD30 between asthmatic and healthy children limits the usefulness of sCD30 as a diagnostic marker of asthma.     

Soluble CD30 serum levels in atopic dermatitis and bronchial asthma and its relationship with disease severity in pediatric age

CD30 is a transmembrane molecule that may be expressed on a proportion of activated T-lymphocytes and has been reported to be a marker of Th2 phenotype. A soluble form of CD30 (sCD30) is released by CD30+ cells in vivo. Our objective was to evaluate serum sCD30 levels in children with atopic dermatitis (AD) or bronchial asthma and to investigate its relation to disease severity. This study included of 60 infants and children, of whom 18 had AD, 22 had bronchial asthma and 20 were healthy matched subjects. Severity of AD was assessed according to the objective Scoring Atopic Dermatitis (obj-SCORAD) index. Laboratory investigations included complete blood count, serum total immunoglobulin E (IgE) and serum sCD30 by ELISA. Serum levels of sCD30 in AD (77.7+/-27.9 U/ml) and asthmatic patients (49.2+/-21.5 U/ml) were significantly increased compared with the control group (18.2+/-7.0 U/ml) (t=8.8, p<0.0001; t=6.4, p<0.0001, respectively). In patients with AD, sCD30 levels were shown to correlate with obj-SCORAD (r=0.96, p<0.0001). Patients with moderate persistent asthma had significantly elevated sCD30 levels than those with mild persistent asthma (t=3.4, p<0.01). In addition, sCD30 was inversely correlated to peak expiratory flow rate (r=-0.78, p<0.0001). Levels of sCD30 did not correlate with age, disease duration or serum total IgE (p>0.05). In conclusion, serum sCD30 levels correlate with the severity of AD and bronchial asthma. It appears to be an additional objective marker that may be useful for follow up and may help to improve research and management of these diseases.     

Soluble CD14 at 2 yr of age: Gender-related effects of tobacco smoke exposure, recurrent infections and atopic diseases

The endotoxin receptor soluble CD14 (sCD14) has been implicated in the 'hygiene hypothesis' suggesting reduced allergic sensitization with bacterial stimulation. However, the relationship between early life sCD14 and allergic diseases is conflicting. We aimed to investigate whether possible risk factors for allergic diseases were associated with sCD14 levels at 2 yr of age. In the nested case-control study of the birth cohort studies 'Environment and Childhood Asthma study in Oslo' 411 children selected with recurrent bronchial obstruction (rBO) (n=241) and no bronchial obstruction (n=170) by 2 yr were investigated with skin prick test and structured parental interview at age 2 yr. Exposure to tobacco smoke, pets and infections was recorded semi-annually by questionnaires (0-2 yr). The sCD14 was analysed from frozen, stored serum by ELISA technique. Regression analyses were performed in all subjects with complete data (n=406, 180 girls), and in girls and in boys separately. Mean sCD14 (ng/ml) was significantly higher among girls 2035 (1973-2096) vs. 1947 (1890-2004) (boys). The sCD14 was significantly reduced among girls exposed to antenatal maternal smoking and with parental asthma, after adjusting for age, parental rhino-conjunctivitis, pet keeping and childhood infections. Recurrent otitis media (OM) increased and common colds significantly decreased sCD14 levels in girls. Boys with atopic dermatitis and rBO had reduced sCD14. Pet exposure was not significantly associated with sCD14. We report novel gender-related effects of sCD14 in early life and suggest that gender, tobacco smoke exposure, age and middle ear disease in particular should be accounted for when assessing the role of sCD14 in childhood allergic diseases.     

Soluble CD30 and CD23 in cord blood are not related to atopy in early childhood

Atopic disease, including atopic dermatitis (AD), is associated with a T-helper 2 (Th2)-dependent immune response. The cytokine receptor CD30 appears to be preferentially expressed on, and its soluble form (sCD30) released by, Th2 cells. Therefore, sCD30 may be a potential marker for atopic disorders. The aim of this study was to test the hypothesis that the sCD30 level in cord blood could be used to predict the development of atopy or AD in early childhood. In a case-control study, levels of sCD30, as well as soluble low-affinity immunoglobulin E (IgE) receptor (sCD23), interleukin-4 (IL-4) and IgE, were measured in cord blood in 35 children who subsequently developed allergic sensitization and AD before the age of three, and the results were compared to those of 35 matched children without a history of atopy. There was no difference in cord blood levels of sCD30 between controls (32.5 U/ml; 19.7–80.1) and children with subsequent atopy and AD (32.2 U/ml; 22–75.9) (median; quartiles). The concentration of sCD30 showed no relation to the levels of total IgE, sCD23 or IL-4. Levels of sCD23 were similar in children with subsequent atopy (60.2 U/ml; 44.5–76.8) and controls (55.2 U/ml; 38.3–72.5), whereas IL-4 was detectable in 10 of the atopic children and in only two of the controls (p < 0.05). In conclusion, cord blood levels of sCD30 or sCD23 do not seem to be related to the subsequent development of atopy or AD at the age of three.     

Soluble CD30 serum antigen in Kawasaki disease

⁴Very high levels of sCD30, a glycoprotein surface antigen expressed by T lymphocytes and other mononuclear cells of the immune system, were found in serum samples from 10 children with typical Kawasaki disease (KD), but not in blood specimens from a vast cohort of paediatric control subjects. These data strongly support an involvement of CD30+T cells in the immune processes which take place at the level of lymphoid organs during the acute phase of KD.     

Soluble receptors to tumour necrosis factor and interleukin-6 in urine during acute pyelonephritis

We compared the urinary concentrations of soluble TNF-I (sTNF-RI), TNF-II receptors, and soluble IL-6 receptor (sIL-6R) standardized to urinary creatinine concentrations, in children with acute pyelonephritis, in children with non-renal fever and in healthy controls. These levels were related to the acute inflammatory response in the kidneys and later renal scarring, as determined by acute and 1-y follow-up with ^99mTC-dimercaptosuccinic acid scintigraphy (DMSA). The concentrations of the soluble receptors were measured using enzyme immunoassay (EIA). The urinary levels of sTNF-RI were significantly higher in children with acute pyelonephritis (median 1320 pg/mmol) than in children with non-renal fever, children 6 weeks after acute pyelonephritis and healthy controls (873, 251 and 477 pg/μmol, respectively). Median sTNF-RII urine levels were also higher in acute pyelonephritis (4123 p/μmol) than in the three control groups (2000, 964 and 1850 pg/μmol, respectively). In contrast, the highest urinary sIL-6R concentrations were found in healthy children (median 420 pg/μmol). compared to those with acute pyelonephritis (235 pg/μmol), children with non-renal fever and children 6 weeks after pyelonephritis (137 and 50 pg/μmol, respectively). No significant difference was found in any of the urinary soluble receptor levels in children with or without DMSA uptake defects at the acute or the 1-y follow-up scintigraphy. In conclusion, although the urinary soluble TNF receptor levels were higher during acute pyelonephritis, this observation was not useful for deciding which children needed follow-up after acute pyelonephritis.     

The impact of serum lipid levels on circulating soluble adhesion molecules in childhood

Cell adhesion molecules play a rather important role in the development of atherosclerosis mediating the attachment of monocytes to the endothelium. It has also been well established that hyperlipidemia is a risk factor for atherosclerosis from childhood. The aim of this study was to investigate whether the soluble adhesion molecules correlate with the circulating lipid levels in children. The study population consisted of 107 children (64 boys, 43 girls) aged 6-13 y. Parental history of cardiovascular disease, age, gender, and anthropometric parameters were recorded in all children. Blood samples were obtained from every child following a 12-hour fasting period. Serum triglycerides, total cholesterol, and its fractions as well as plasma levels of P and E selectins and adhesion molecules sVCAM-1 and sICAM-1 were determined. After controlling for age and body mass index, both sVCAM-1 and sP-selectin levels were inversely associated with HDL values (r = -0.33, p = 0.005 and r = -0.39, p = 0.001, respectively). A significant positive correlation was found between sVCAM-1 and triglycerides (r = 0.48, p < 0.001). An increment of 10 mg/dL of HDL corresponds to about 50% reduction of the odds for endothelial dysfunction whereas an increment of 10 mg/dL of triglyceride levels indicates a more than 3-fold excess risk, using either sP-selectin or sVCAM-1 levels as a surrogate for the determination of endothelial dysfunction. We suggest that HDL-C and triglycerides correlate in a biologically plausible way with soluble adhesion molecules, which therefore could be considered as useful indicators of the process of preclinical atherosclerosis even from childhood.     

过敏性紫癜患儿可溶性血管细胞黏附分子-1、免疫球蛋白A抗内皮细胞抗体检测的意义

目的探讨可溶性血管细胞黏附分子-1(SVCAM-1)、IgA抗内皮细胞抗体(IgAAECA)在过敏性紫癜(HSP)诊断中的价值及两者的关系。方法采用ELISA检测55例HSP患儿(其中急性期40例,恢复期15例),20例健康儿血清SVCAM-1水平,应用荧光免疫印片法检测IgAAECA阳性率。结果HSP肾炎组SVCAM-1较非肾炎组明显升高,且急性期高于恢复期,差异均有显著意义(P均<0.01)。HSP肾炎组IgAAECA阳性率明显高于无肾炎组,IgAAECA阳性组SVCAM-1高于阴性组,差异均有显著意义(P均<0.01)。结论SVCAM-1、IgAAECA参与HSP的发病过程,可反映疾病进展程度。