CD40L、可溶性黏附分子及MMP9在川崎病中的表达及意义

目的：研究T细胞CD40配体（CD40L）、血浆中可溶性E选择素（sE-selectin）、可溶性细胞间黏附分子1（sICAM-1）和基质金属蛋白酶9（MMP9）在川崎病中的表达及意义。方法：用流式细胞双色荧光标记技术检测20例川崎病急性期及静脉注射免疫球蛋白（IVIG）治疗后的患儿，19例正常对照，外周血T细胞表达CD40L阳性细胞率及平均荧光强度；用ELISA方法检测上述3组血浆中sE—selectin、sICAM-1和MMP9水平。结果：急性期川崎病组T细胞CD40L表达明显高于IVIG治疗后组（P〈0．05），川崎病患儿T细胞CD40L表达较正常对照持久；2例伴冠状动脉损害（CAL）的川崎病患儿急性期T细胞CD40L表达高于无CAL者。急性期川崎病组血浆sICAM-1、MMP9明显高于IVIG治疗后组，急性期川崎病患儿血浆sE—selectin、sICAM—1明显高于正常对照（P〈0.05）。川崎病急性期T细胞表达CD40L与血浆sE—selectin、sICAM-1、MMP9水平无明确相关性（P〉0．05）。结论：T细胞表达CD40L升高在川崎病血管炎及冠状动脉病变中可能起一定作用。血浆sE-selectin、sLCAM-1和MMP9水平可作为反映川崎病血管炎的指标。

Significance of T cell CD40L, soluble adhesion molecules and MMP9 in Kawasaki disease

Objective:To study the significance of T cell CD40L, plasma sE-selectin, sICAM-1 and MMP9 in the pathogenesis of KD.Methods:The expressions of T cell CD40L were detected by 2-color flow cytometry and the levels of plasma sE-selectin, sICAM-1 and MMP9 were detected by ELISA in 20 KD patients pre and post IVIG, and 19 normal children.Results:The expressions of T cell CD40L were significantly higher compared pre-IVIG with post-IVIG in KD patients(P<0.05). The expressions of T cell CD40L in KD patients were prolonged compared with normal control. The expressions of T cell CD40L in 2 KD patients with coronary artery lesions(CAL) were higher than patients without CAL in the acute phase. The plasma levels of sE-selectin and sICAM-1 in the acute phase of KD patients were elevated in comparison to normal children. Paired analysis of KD patients pre and post IVIG revealed lower levels of sICAM-1and MMP9(P<0.05). Correlation was not found between T cell CD40L and plasma sE-selectin, sICAM-1 and MMP9(P>0.05).Conclusion:T cell CD40L may probably play a role in the pathogenesis of vasculitis and coronary artery lesions of KD. The plasma levels of sE-selectin, sICAM-1 and MMP9 may be used to reflect the degree of vasculitis of KD.