Francis R B, Haywood L J
Department of Medicine, University of Southern California School of Medicine, Los Angeles 90033.
J Natl Med Assoc. 1992 Jul;84(7):611-5.
To determine whether tumor necrosis factor (TNF) and interleukin-1 (IL-1) might be involved in the pathogenesis of sickle cell disease and its complications, TNF-alpha and IL-1-alpha were measured using enzyme-linked immunosorbent assay in 59 plasma samples from 34 adult subjects with Hb SS or Hb SC who did not have documented infections. Tumor necrosis factor was elevated on at least one occasion in 27 subjects, including 18 of 21 subjects in the steady state and 13 of 19 subjects during painful crisis. Interleukin-1 was elevated on at least one occasion in 6 subjects, including 3 subjects in the steady state and 3 subjects in crisis. All subjects with elevated IL-1 also had elevated TNF. Tumor necrosis factor and IL-1 were similarly elevated in the steady state and during painful crisis. No correlation was noted between TNF or IL-1 levels and the extent of activation of coagulation, as measured by plasma levels of the fibrin D-dimer fragment, the overall severity of vascular occlusive disease in each subject, or the presence of specific vascular occlusive complications. We conclude that plasma TNF is frequently elevated in subjects with sickle cell disease, and IL-1 is also elevated in some subjects. A direct role for these cytokines in the pathogenesis of vascular occlusion in sickle cell disease was not demonstrated, but an indirect role was not excluded.
为了确定肿瘤坏死因子（TNF）和白细胞介素-1（IL-1）是否可能参与镰状细胞病及其并发症的发病机制，采用酶联免疫吸附测定法对34例无感染记录的成年Hb SS或Hb SC患者的59份血浆样本进行了TNF-α和IL-1-α检测。27例患者至少有一次肿瘤坏死因子升高，包括21例稳定期患者中的18例和19例疼痛危象期患者中的13例。6例患者至少有一次白细胞介素-1升高，包括3例稳定期患者和3例危象期患者。所有白细胞介素-1升高的患者肿瘤坏死因子也升高。肿瘤坏死因子和白细胞介素-1在稳定期和疼痛危象期同样升高。通过血浆纤维蛋白D-二聚体片段水平测定，未发现TNF或IL-1水平与凝血激活程度、各患者血管闭塞性疾病的总体严重程度或特定血管闭塞性并发症的存在之间存在相关性。我们得出结论，镰状细胞病患者血浆TNF经常升高，部分患者IL-1也升高。这些细胞因子在镰状细胞病血管闭塞发病机制中的直接作用未得到证实，但也未排除间接作用。
