Wang Yan, Li Chunli, Niu Ling, Fu Mingyu, Tian Jing, An Xinjiang
Department of Cardiovascular Medicine, Xuzhou Children's Hospital Affiliated to Xuzhou Medical University, Xuzhou, Jiangsu 221006, P.R. China.
Exp Ther Med. 2021 Feb;21(2):162. doi: 10.3892/etm.2020.9593. Epub 2020 Dec 18.
The present study aimed to investigate the expression of microRNAs (miRNAs/miRs) and inflammatory factors in patients with immunoglobulin-sensitive and IVIG-insensitive incomplete Kawasaki disease (KD). One hundred and eighty-five patients with incomplete KD were included as the study group (KD group), and 182 patients with respiratory infection as the control group. Neutrophil to lymphocyte ratio (NLR), C-reactive protein (CRP) levels, alanine aminotransferase (ALT), aspartate aminotransferase (AST), white blood cell count (WBC), hemoglobin level (Hb), platelet count (PLT) and T cell subsets (CD3, CD3 CD4) were compared. Patients in the KD group received aspirin (30 mg/kg orally daily) and gamma globulin (IVIG, 1 g/kg intravenously daily). According to the sensitivity to IVIG, patients were divided into IVIG-sensitive group and IVIG-insensitive KD group. The relative expression levels of miRNA-21, miRNA-145, miRNA-155 and miRNA-199b-5p in the serum were detected by RT-qPCR. Serum TNF-α, IL-6 and IL-1β levels were assessed using ELISA. Before treatment, the neutrophil to lymphocyte ratio (NLR), levels C-reactive protein, and leukocytes in the KD group were significantly higher compared with the control group (P<0.05). After medical intervention, the relative expression of miRNA-21, miRNA-145 and miRNA-155 in the serum of patients in IVIG-sensitive and IVIG-insensitive KD groups were increased when compared with these levels in the control group (P<0.05). Meanwhile, the relative expression of miRNA-199b-5p was decreased (P<0.05). Compared with the IVIG-sensitive KD group, the relative expression levels of miRNA-145 and miRNA-155 were increased in the serum of patients in the IVIG-insensitive KD group (P<0.05). Compared with the control group, the levels of TNF-α, IL-6 and IL-1β were increased in the serum of patients in the IVIG-sensitive and IVIG-insensitive KD groups (P<0.05). Compared with the IVIG-sensitive KD group, the serum levels of TNF-α and IL-6 were increased in patients of the IVIG-insensitive KD group (P<0.05). Except for NLR and CRP, there were differences in the expression of peripheral blood miRNA-145, miRNA-155 and serum TNF-α and IL-6 in patients with immunoglobulin-sensitive and -insensitive incomplete KD.
本研究旨在调查免疫球蛋白敏感型和静脉注射免疫球蛋白（IVIG）不敏感型不完全川崎病（KD）患者体内微小RNA（miRNA/miR）和炎症因子的表达情况。185例不完全KD患者被纳入研究组（KD组），182例呼吸道感染患者作为对照组。比较两组患者的中性粒细胞与淋巴细胞比值（NLR）、C反应蛋白（CRP）水平、丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、白细胞计数（WBC）、血红蛋白水平（Hb）、血小板计数（PLT）以及T细胞亚群（CD3、CD3 CD4）。KD组患者接受阿司匹林（每日口服30mg/kg）和丙种球蛋白（IVIG，每日静脉注射1g/kg）治疗。根据对IVIG的敏感性，将患者分为IVIG敏感组和IVIG不敏感KD组。采用逆转录定量聚合酶链反应（RT-qPCR）检测血清中miRNA-21、miRNA-145、miRNA-155和miRNA-199b-5p的相对表达水平。采用酶联免疫吸附测定（ELISA）评估血清肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）和白细胞介素-1β（IL-1β）水平。治疗前，KD组患者的中性粒细胞与淋巴细胞比值、C反应蛋白水平和白细胞水平显著高于对照组（P<0.05）。医学干预后，IVIG敏感和IVIG不敏感KD组患者血清中miRNA-21、miRNA-145和miRNA-155的相对表达水平较对照组升高（P<0.05）。同时，miRNA-199b-5p的相对表达水平降低（P<0.05）。与IVIG敏感KD组相比，IVIG不敏感KD组患者血清中miRNA-145和miRNA-155的相对表达水平升高（P<0.05）。与对照组相比，IVIG敏感和IVIG不敏感KD组患者血清中TNF-α、IL-6和IL-1β水平升高（P<0.05）。与IVIG敏感KD组相比，IVIG不敏感KD组患者血清中TNF-α和IL-6水平升高（P<0.05）。除NLR和CRP外，免疫球蛋白敏感型和不敏感型不完全KD患者外周血miRNA-145、miRNA-155以及血清TNF-α和IL-6的表达存在差异。
