Department of Pediatrics, Haseki Educational and Research Hospital, Istanbul, Turkey.
Pediatr Nephrol. 2011 Nov;26(11):1989-93. doi: 10.1007/s00467-011-1905-y. Epub 2011 May 8.
Henoch-Schonlein purpura (HSP) is a systemic vasculitis characterized by involvement of skin, joints, gastrointestinal tract (GIT), and kidney; its pathogenesis is still controversial. The aim of our study was to investigate the role of oxidative stress in the pathogenesis of HSP. Plasma advanced oxidation protein products (AOPP) level was measured in 29 children with HSP at the onset of the disease and during remission in comparison with 30 healthy subjects. Patients at the active stage had significantly higher AOPP levels than those at the remission stage of HSP and the controls (42.9 ± 25.7, 30.6 ± 11.8, 27.9 ± 11.2 mmol/l; P = 0.027 and P = 0.023 respectively). The mean AOPP levels of the patients with arthritis and/or arthralgia were significantly higher those than without joint involvement (48.3 ± 26.0 and 22.3 ± 9.3, P = 0.036 respectively). However, AOPP levels were similar in patients with and without gastrointestinal involvement. Plasma AOPP levels were positively correlated with leukocyte and thrombocyte count at disease onset, whereas they were found to be negatively correlated with serum glucose and sodium levels. The mean thrombocyte count was the only independent predictor of increased level of AOPP in regression analysis (β = 0.407; P = 0.029). In conclusion, this study showed that increased oxidative stress may play an important role in the pathogenesis of HSP. Also, we suggest that higher platelet count might be an indirect indicator of oxidative stress in these patients. Further research is required to identify the potential association between oxidative stress and increased thrombocyte count in children with HSP.
过敏性紫癜(HSP)是一种全身性血管炎,其特征为皮肤、关节、胃肠道(GIT)和肾脏受累;其发病机制仍存在争议。我们的研究旨在探讨氧化应激在 HSP 发病机制中的作用。测定了 29 例 HSP 患儿发病期和缓解期的血浆晚期氧化蛋白产物(AOPP)水平,并与 30 例健康对照者进行比较。活动期患者的 AOPP 水平明显高于 HSP 缓解期和对照组患者(42.9±25.7、30.6±11.8、27.9±11.2mmol/L;P=0.027 和 P=0.023)。伴关节炎和/或关节痛的患者 AOPP 均值明显高于无关节受累者(48.3±26.0 和 22.3±9.3,P=0.036)。然而,有胃肠道受累者与无胃肠道受累者的 AOPP 水平相似。血浆 AOPP 水平与发病时白细胞和血小板计数呈正相关,与血清葡萄糖和钠水平呈负相关。回归分析显示,血小板计数均值是 AOPP 水平升高的唯一独立预测因子(β=0.407;P=0.029)。总之,本研究表明,氧化应激增加可能在 HSP 的发病机制中起重要作用。此外,我们建议血小板计数升高可能是这些患者氧化应激的间接指标。需要进一步研究以确定 HSP 患儿氧化应激与血小板计数升高之间的潜在关联。