Hamaguchi Y, Majima Y, Ukai K, Sakakura Y, Miyoshi Y
Ann Otol Rhinol Laryngol Suppl. 1986 May-Jun;124:5-8. doi: 10.1177/00034894860950s302.
Significance of the kallikrein-kinin system in the pathogenesis of otitis media with effusion (OME) was evaluated by prekallikrein level, kallikrein activity, and concentration of high molecular weight (HMW) kininogen in 45 middle ear effusions (MEEs, 38 serous and seven mucoid). All MEEs had varying prekallikrein levels (73.1 +/- 127.5 relative fluoro units [RFU]), and the mean value in serous effusions (82.2 RFU) was much higher than that in mucoid effusions (23.0 RFU). Hydrolytic activity of kallikrein in serous effusions was 18.0 +/- 27.9 RFU, and was significantly higher than that in mucoid effusions (8.0 +/- 4.2 RFU, p less than 0.05). Concentration of HMW kininogen in serous effusions was 51.2 +/- 72.77% of plasma value, but it could not be detected in any mucoid effusions. Analysis of protein composition by polyacrylamide gel electrophoresis indicates that plasma protein that has leaked into the middle ear is a major component of MEEs. The kallikrein-kinin system would be active in serous effusions, and liberated bradykinin enhances vascular permeability in the middle ear mucosa, leading to profuse plasma leakage, which characterizes the component of serous effusions. On the other hand, this system would almost be consumed in mucoid effusions.
通过测定45例中耳积液（MEE，38例浆液性和7例黏液性）中的前激肽释放酶水平、激肽释放酶活性和高分子量（HMW）激肽原浓度，评估激肽释放酶-激肽系统在分泌性中耳炎（OME）发病机制中的意义。所有MEE的前激肽释放酶水平各不相同（73.1±127.5相对荧光单位[RFU]），浆液性积液中的平均值（82.2 RFU）远高于黏液性积液中的平均值（23.0 RFU）。浆液性积液中激肽释放酶的水解活性为18.0±27.9 RFU，显著高于黏液性积液中的水解活性（8.0±4.2 RFU，p<0.05）。浆液性积液中HMW激肽原的浓度为血浆值的51.2±72.77%，但在任何黏液性积液中均未检测到。聚丙烯酰胺凝胶电泳分析蛋白质组成表明，漏入中耳的血浆蛋白是MEE的主要成分。激肽释放酶-激肽系统在浆液性积液中具有活性，释放的缓激肽可增强中耳黏膜的血管通透性，导致大量血浆渗漏，这是浆液性积液成分的特征。另一方面，该系统在黏液性积液中几乎被消耗殆尽。
