Edwards S W, Say J E, Taylor J, Hart C A
Department of Biochemistry, University of Liverpool, UK.
J Clin Lab Immunol. 1988 Oct;27(2):97-102.
We describe a case of a 5-year-old male patient with prolonged and extensive osteomyelitis of the left femur. Staphylococcus aureus was grown from blood cultures taken upon admission and also from pus drained from an incised hip joint. A defect in immune function was suspected and neutrophil function was assessed. Chemotaxis and phagocytosis were normal, but phagocytosed S. aureus were not killed as efficiently as in control neutrophils. No inherent defect in the ability of these neutrophils to generate reactive oxidants was observed, but an unusual luminol-dependent chemiluminescence response was obtained during phagocytosis of latex beads or opsonized S. aureus: This was characterized by an initial rapid, but transient increase occurring within 1 min of addition of phagocytic stimulus. Whereas during phagocytosis of latex beads by control neutrophils less than 1% of the total myeloperoxidase activity was detected extracellularly, up to 15% was released from the patient's neutrophils. We propose that release of myeloperoxidase from the patient's neutrophils during phagocytosis reduces the intraphagosomal concentration of this enzyme and thus impairs the efficiency of intracellular killing of S. aureus.
我们描述了一例5岁男性患者，患有左股骨长期广泛的骨髓炎。入院时采集的血培养物以及切开髋关节引流的脓液中均培养出金黄色葡萄球菌。怀疑存在免疫功能缺陷，并对中性粒细胞功能进行了评估。趋化性和吞噬作用正常，但吞噬的金黄色葡萄球菌没有像对照中性粒细胞那样被有效杀灭。未观察到这些中性粒细胞产生活性氧化剂的能力存在内在缺陷，但在吞噬乳胶珠或调理素化的金黄色葡萄球菌过程中获得了异常的鲁米诺依赖性化学发光反应：其特征是在添加吞噬刺激后1分钟内出现初始快速但短暂的增加。对照中性粒细胞吞噬乳胶珠时，细胞外检测到的总髓过氧化物酶活性不到1%，而患者的中性粒细胞释放的活性高达15%。我们认为，患者中性粒细胞在吞噬过程中释放髓过氧化物酶会降低该酶在吞噬体内的浓度，从而损害细胞内杀灭金黄色葡萄球菌的效率。
