Blijlevens N M A, Donnelly J P, DePauw B E
Department of Haematology, University Medical Centre St Radboud Nijmegen, Nijmegen, The Netherlands.
Bone Marrow Transplant. 2005 Oct;36(8):703-7. doi: 10.1038/sj.bmt.1705118.
We noted a significant increase of interleukin-8 (IL-8), LBP and CRP mirroring the pattern of mucosal barrier injury as measured by gut integrity (lactulose/rhamnose ratio), daily mucositis score (DMS) and serum citrulline concentrations of 32 haematopoietic stem cell transplant (HSCT) recipients following intensive myeloablative therapy. Concentrations of IL-8, LBP and CRP were already significantly elevated before the onset of fever or bacteraemia due to oral viridans streptococci (OVS) in the first week after transplant during profound neutropenia. These markers reached their peak when citrulline concentrations reached their nadir, the highest scores of DMS were attained and when there was significantly decreased gut integrity. This suggests that the degree of mucosal barrier injury rather than bacteraemia due to OVS determines the intensity of the inflammatory response.
我们注意到，在32名接受强化清髓治疗的造血干细胞移植（HSCT）受者中，白细胞介素-8（IL-8）、脂多糖结合蛋白（LBP）和C反应蛋白（CRP）显著增加，这与通过肠道完整性（乳果糖/鼠李糖比率）、每日黏膜炎评分（DMS）和血清瓜氨酸浓度所测量的黏膜屏障损伤模式一致。在移植后第一周严重中性粒细胞减少期间，由于口腔草绿色链球菌（OVS）导致发热或菌血症发作之前，IL-8、LBP和CRP的浓度就已经显著升高。当瓜氨酸浓度降至最低点、DMS达到最高分且肠道完整性显著降低时，这些标志物达到峰值。这表明，黏膜屏障损伤的程度而非OVS导致的菌血症决定了炎症反应的强度。
