抗菌肽作为结节病和结核病之间的联系。

Cathelicidin as a link between sarcoidosis and tuberculosis.

作者信息

Korucu Ercan, Pur Ozyigit Leyla, Ortakoylu Mediha Gonenc, Bahadir Ayse, Akalin Esma Seda, Kara Asuman, Uzun Hafize, Onal Burak, Caglar Emel

机构信息

Yedikule Chest Diseases and Surgery Education and Research Hospital, Istanbul.

出版信息

Sarcoidosis Vasc Diffuse Lung Dis. 2015 Sep 14;32(3):222-7.

PMID:26422567

Abstract

SETTING

Sarcoidosis and tuberculosis share notable clinical, radiological, histological, and immunological similarities. The importance of vitamin D has long been investigated in these two granulomatous lung diseases. Cathelicidin is an antimicrobial peptide of the innate immune system, directly induced by vitD3.

OBJECTIVE

To evaluate the role of cathelicidin in sarcoidosis and tuberculosis development.

DESIGN

The study included 30 consecutive patients with active lung tuberculosis, 30 patients with sarcoidosis, and 20 healthy controls. 25-hydroxyvitamin D [25(OH)D] and cathelicidin levels were measured in blood samples.

RESULTS

Vitamin D levels were significantly higher (p<0.001) in tuberculosis patients (22.5 ± 9.96 ng/ml) than in sarcoidosis patients (11.75 ± 8.92 ng/ml). Severe vitamin D deficiency was as frequent as 47% in sarcoidosis patients compared to only 3% in tuberculosis patients. Cathelicidin levels were significantly higher in the control group (120.37 ± 41.03 pg/ml) than in sarcoidosis (67.68 ± 38.03 pg/ml) and tuberculosis (68.74 ± 39.44 pg/ml) patients (p<0.001). However, no significant difference in cathelicidin levels was observed between tuberculosis and sarcoidosis patients (p=0.966). The optimum cathelicidin cut-off value to distinguish sarcoidosis patients from healthy controls was 107.14 pg/ml (sensitivity 81.5%, specificity 71.2%).

CONCLUSION

Cathelicidin appears to play different roles in the development of granulomatous lung disease.

摘要

背景

结节病和结核病在临床、放射学、组织学及免疫学方面存在显著相似之处。长期以来，维生素D在这两种肉芽肿性肺病中的作用一直受到研究。cathelicidin是一种先天性免疫系统的抗菌肽，由维生素D3直接诱导产生。

目的

评估cathelicidin在结节病和结核病发病过程中的作用。

设计

该研究纳入了30例连续的活动性肺结核患者、30例结节病患者及20名健康对照者。检测血样中的25-羟维生素D[25(OH)D]和cathelicidin水平。

结果

肺结核患者的维生素D水平（22.5±9.96 ng/ml）显著高于结节病患者（11.75±8.92 ng/ml）（p<0.001）。结节病患者中重度维生素D缺乏的发生率高达47%，而肺结核患者仅为3%。对照组的cathelicidin水平（120.37±41.03 pg/ml）显著高于结节病患者（67.68±38.03 pg/ml）和肺结核患者（68.74±39.44 pg/ml）（p<0.001）。然而，肺结核患者和结节病患者之间的cathelicidin水平未观察到显著差异（p=0.966）。区分结节病患者与健康对照者的最佳cathelicidin临界值为107.14 pg/ml（敏感性81.5%，特异性71.2%）。