Abe Y, Nakano S, Nakahara T, Kamezawa Y, Kato I, Ushijima H, Yoshino K, Ito S, Noma S, Okitsu S
Department of Pathology, Teikyo University School of Medicine, Japan.
Pediatr Res. 1990 Jan;27(1):11-5. doi: 10.1203/00006450-199001000-00003.
We describe a new method to measure human serum antibody against streptococcal erythrogenic toxins that uses inhibition of lymphocyte mitogenicity of the toxins as the indicator. Sera from 53% of 53 Kawasaki disease patients contained specific inhibitory activity against A toxin, whereas only 15% had serum inhibitory activity against B toxin. The specific anti-A toxin serum inhibitor was found in 10% of 118 age-matched control patients suffering from various infections and allergic diseases (p = 0.001, compared to Kawasaki disease patients). Serum inhibitory activity was detected in a small number of patients with beta-hemolytic streptococcal infection (3/19) and in none of the age-matched healthy children (0/17). However, four of seven cord blood sera samples and five of 13 sera samples from healthy neonates contained the inhibitor, a result suggesting passive transfer from mothers. Most of the antimitogen-positive sera were also positive by ELISA of IgG antibody against A toxin, and IgG fractions of the positive sera remained positive in both assays. Thus, it is possible that the specific serum inhibitor detected by the antimitogen assay represents anti-A toxin antibody. The role of toxin-producing bacteria in the pathogenesis of Kawasaki disease remains to be investigated.
我们描述了一种测量人血清中抗链球菌致热毒素抗体的新方法，该方法以毒素对淋巴细胞有丝分裂原性的抑制作用为指标。53例川崎病患者中，53%的血清含有针对A毒素的特异性抑制活性，而只有15%的患者血清对B毒素具有抑制活性。在118例患有各种感染和过敏性疾病的年龄匹配对照患者中，10%的患者发现了特异性抗A毒素血清抑制剂（与川崎病患者相比，p = 0.001）。在少数β溶血性链球菌感染患者（3/19）中检测到血清抑制活性，而在年龄匹配的健康儿童中均未检测到（0/17）。然而，7份脐带血血清样本中有4份以及13份健康新生儿血清样本中有5份含有该抑制剂，这一结果提示该抑制剂是由母亲被动传递而来。大多数抗有丝分裂原阳性血清通过抗A毒素IgG抗体的ELISA检测也呈阳性，并且阳性血清的IgG组分在两种检测中均保持阳性。因此，通过抗有丝分裂原检测法检测到的特异性血清抑制剂可能代表抗A毒素抗体。产毒素细菌在川崎病发病机制中的作用仍有待研究。
