Ece Aydin, Kelekçi Selvi, Hekimoğlu Aşkin, Kocamaz Halil, Balik Hasan, Yolbaş Ilyas, Erel Ozcan
Department of Pediatrics, Dicle University, Medical School, Diyarbakir, Turkey.
Pediatr Nephrol. 2007 Aug;22(8):1151-7. doi: 10.1007/s00467-007-0475-5. Epub 2007 Apr 3.
The aim of this study was to investigate the role of neutrophil activation, protein oxidation and ceruloplasmin (CLP) in the pathogenesis of Henoch-Schönlein purpura (HSP), which has not been investigated previously. Serum activities of myeloperoxidase (MPO) and arylesterase (ARYL) and levels of free thiol groups, CLP and total oxidant status (TOS) were measured in 29 children with HSP at the onset of the disease and during remission in comparison with 30 healthy subjects. Patients at active stage had significantly higher MPO activity (391+/-277 vs. 155+/-154 U/l, P<0.001), higher CLP (832+/-120 vs. 682+/-114 mg/dl, P<0.001) and TOS values (20.7+/-11.8 vs. 7.5+/-2.8 micromol H2O2/l, P<0.001) than the controls, respectively. Patients had significantly lower ARYL activity (158x10(3)+/-39x10(3) vs. 187x10(3)+/-46x10(3) U/l, P<0.001) and lower free thiol levels (234+/-48 vs. 279+/-26 micromol/l, P<0.001) than the controls, respectively. Significantly positive correlations were found between TOS and MPO (r=0.437, P=0.018) and TOS and CLP (r=0.409, P=0.028) at disease onset, whereas a negative correlation was found between MPO and thiol (r=-0.597, P=0.001) during remission. In conclusion, protein oxidation and neutrophil activation may play important roles in the pathogenesis of HSP. Further research is required to understand the potential linkage between oxidant stress and complications and to develop therapeutic strategies in HSP.
本研究的目的是调查中性粒细胞活化、蛋白质氧化和铜蓝蛋白(CLP)在过敏性紫癜(HSP)发病机制中的作用,此前尚未对此进行过研究。对29例HSP患儿在疾病发作时和缓解期的血清髓过氧化物酶(MPO)和芳基酯酶(ARYL)活性、游离巯基水平、CLP和总氧化状态(TOS)进行了检测,并与30名健康受试者进行了比较。活动期患者的MPO活性(391±277 vs. 155±154 U/l,P<0.001)、CLP(832±120 vs. 682±114 mg/dl,P<0.001)和TOS值(20.7±11.8 vs. 7.5±2.8 μmol H2O2/l,P<0.001)均显著高于对照组。患者的ARYL活性(158×10³±39×10³ vs. 187×10³±46×10³ U/l,P<0.001)和游离巯基水平(234±48 vs. 279±26 μmol/l,P<0.001)均显著低于对照组。在疾病发作时,TOS与MPO(r=0.437,P=0.018)以及TOS与CLP(r=0.409,P=0.028)之间存在显著正相关,而在缓解期MPO与巯基之间存在负相关(r=-0.597,P=0.001)。总之,蛋白质氧化和中性粒细胞活化可能在HSP的发病机制中起重要作用。需要进一步研究以了解氧化应激与并发症之间的潜在联系,并制定HSP的治疗策略。