Pertosa G, Mastrolitti G, Späth P J, Fracasso A R, Manno C, Schena F P
Chair of Medical Therapy, University of Bari, Italy.
Nephrol Dial Transplant. 1989;4(1):15-20.
The influence of human fibronectin was evaluated on the phagocytosis in vitro of C. albicans (C3b receptor-mediated) and IgG antibody-coated sheep erythrocytes (Fc receptor-mediated) by the peripheral blood monocytes of 40 uraemic patients undergoing periodic haemodialysis. Some nutritional parameters (albumin, transferrin, C4, C3, haematocrit, lymphocyte count, height and bodyweight) were also evaluated. Results showed significantly decreased plasma fibronectin (P less than 0.001) and reduced C3b receptor (R)- and FcR-mediated phagocytosis in uraemic patients (P less than 0.001). A strict correlation was found between fibronectin and C3bR-mediated phagocytosis (P less than 0.001) and between fibronectin and FcR-mediated phagocytosis (P less than 0.05). In 20 patients with decreased fibronectin concentrations and reduced phagocytic function, the in vitro incubation of peripheral blood monocytes with 50 micrograms/ml of purified fibronectin significantly enhanced C3bR-(P less than 0.001) but not FcR-mediated phagocytosis. Study of nutritional parameters in the uraemic patients revealed that values of fibronectin, C3, IgG and albumin were significantly reduced. Fibronectin correlated significantly (P less than 0.001) with C3. A good relationship (P less than 0.05) was also found between the plasma fibronectin and bodyweight loss. A greater incidence of infectious disease was observed in patients with decreased plasma fibronectin than in uraemic patients with normal values (P less than 0.05). The results suggest that a decrease in plasma fibronectin in uraemic patients could impair the peripheral blood monocyte phagocytic capacity and be potentially dangerous, predisposing the patient to infections. The determination of fibronectin concentration in these patients may, therefore, have a potential value as an indicator of peripheral blood monocyte phagocytic function.
通过对40例接受定期血液透析的尿毒症患者外周血单核细胞进行体外实验，评估人纤连蛋白对白色念珠菌（C3b受体介导）和IgG抗体包被的绵羊红细胞（Fc受体介导）吞噬作用的影响。同时还评估了一些营养参数（白蛋白、转铁蛋白、C4、C3、血细胞比容、淋巴细胞计数、身高和体重）。结果显示，尿毒症患者血浆纤连蛋白显著降低（P<0.001），C3b受体（R）和FcR介导的吞噬作用也降低（P<0.001）。纤连蛋白与C3bR介导的吞噬作用之间存在严格的相关性（P<0.001），与FcR介导的吞噬作用之间也存在相关性（P<0.05）。在20例纤连蛋白浓度降低且吞噬功能受损的患者中，用50微克/毫升纯化纤连蛋白对其外周血单核细胞进行体外孵育，可显著增强C3bR介导的吞噬作用（P<0.001），但不能增强FcR介导的吞噬作用。对尿毒症患者营养参数的研究表明，纤连蛋白、C3、IgG和白蛋白的值显著降低。纤连蛋白与C3显著相关（P<0.001）。血浆纤连蛋白与体重减轻之间也存在良好的关系（P<0.05）。血浆纤连蛋白降低的患者比纤连蛋白值正常的尿毒症患者感染性疾病的发生率更高（P<0.05）。结果表明，尿毒症患者血浆纤连蛋白的降低可能会损害外周血单核细胞的吞噬能力，具有潜在危险性，使患者易发生感染。因此，测定这些患者的纤连蛋白浓度可能具有作为外周血单核细胞吞噬功能指标的潜在价值。
