Ueno Kentaro, Nomura Yuichi, Morita Yasuko, Eguchi Taisuke, Masuda Kiminori, Kawano Yoshifumi
Department of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences.
Circ J. 2015;79(6):1349-56. doi: 10.1253/circj.CJ-14-1323. Epub 2015 Mar 19.
Circulating platelet-neutrophil aggregates play a crucial role in amplifying acute inflammation and could promote adverse effects involving vascular injury. The aim of this study was to evaluate the role of platelet-neutrophil aggregates in Kawasaki disease (KD).
Forty patients with KD (30 intravenous immunoglobulin [IVIG] responders and 10 IVIG non-responders), 7 febrile patients with bacterial infections, and 9 normal volunteers were analyzed. Thirty-three patients with KD were treated with IVIG, and 7 were treated with IVIG plus prednisolone. We evaluated the rate of platelet-neutrophil aggregates and measured the platelet factor 4 (PF4) and β-thromboglobulin (β-TG) levels. The rate of platelet-neutrophil aggregates was significantly higher in patients with KD than those with bacterial infection and normal volunteers. The rate of platelet-neutrophil aggregates was significantly higher in patients with coronary artery abnormalities (CAA) than in those without CAA, and was correlated with PF4 and β-TG levels in patients with KD. Comparing time-course analysis, the rate of platelet-neutrophil aggregates was significantly decreased in patients treated with IVIG plus prednisolone than in those treated with IVIG alone.
The findings demonstrate that platelet-neutrophil aggregates are significantly present in higher rates and are closely related to pathological developments of CAA in KD. Additional prednisolone treatment for patients in the acute phase of KD could suppress platelet-neutrophil aggregates, indicating that platelet-neutrophil aggregates would inhibit amplified reciprocal vascular inflammatory activation.
循环中的血小板-中性粒细胞聚集体在放大急性炎症中起关键作用，并可能促进涉及血管损伤的不良反应。本研究的目的是评估血小板-中性粒细胞聚集体在川崎病（KD）中的作用。
分析了40例KD患者（30例静脉注射免疫球蛋白[IVIG]反应者和10例IVIG无反应者）、7例发热细菌感染患者和9名正常志愿者。33例KD患者接受IVIG治疗，7例接受IVIG加泼尼松龙治疗。我们评估了血小板-中性粒细胞聚集体的比率，并测量了血小板因子4（PF4）和β-血小板球蛋白（β-TG）水平。KD患者的血小板-中性粒细胞聚集体比率显著高于细菌感染患者和正常志愿者。冠状动脉异常（CAA）患者的血小板-中性粒细胞聚集体比率显著高于无CAA患者，且与KD患者的PF4和β-TG水平相关。比较时间进程分析，IVIG加泼尼松龙治疗的患者血小板-中性粒细胞聚集体比率显著低于单独接受IVIG治疗的患者。
研究结果表明，血小板-中性粒细胞聚集体在KD中显著以更高比率存在，且与CAA的病理发展密切相关。在KD急性期对患者额外使用泼尼松龙治疗可抑制血小板-中性粒细胞聚集体，表明血小板-中性粒细胞聚集体会抑制放大的相互血管炎症激活。
