Vasil'ev S A, Savchenko V G, Margulis E Ia, Ermolin G A, Kotelianskiĭ V E
Ter Arkh. 1985;57(7):119-24.
Plasma fibronectin is regarded to play an important part in a decrease of the resistance to infections. To specify the role of fibronectin in the pathogenesis of infectious complications in patients with depressions of hemopoiesis, the content of this opsonin was measured by ELISA in 113 patients with different patterns of hemoblastoses, lymphoproliferative diseases and with an aplastic syndrome. In 42 patients, the concentration of opsonin was measured in the presence of the superimposed infection of varying gravity. The fibronectin content was examined in 39 patients before, during and after completion of the cytostatic polychemotherapy. It turned out that in patients with paraproteinemic hemoblastoses, lymphogranulomatosis, aplastic anemia, chronic lympholeukemia, acute lympho- and myelo(mono)blastic leukemias, cyclic neutropenia, chronic myelosis and hematosarcomas, the concentration of fibronectin remained normal in the absence of infections. The computation of the linear correlation ratio did not reveal any association between the opsonin level and the concentration of neoplastic elements in the peripheral blood. Repeated measurements of the fibronectin level in patients whose underlying disease ran its course in association with marked neoplastic fever failed to detect any deficiency of the glycoprotein. The lowering of the fibronectin level was recorded in patients with a grave concomitant infection of the type of sepsis, necrotic enteropathy and lobar pneumonia. The degree of opsonin deficiency correlated with the patients' disease gravity. Prolonged reduction in the blood fibronectin level was of unfavourable prognostic importance. Cytostatic polychemotherapy, myelotoxic agranulocytosis as well as infectious complications of low gravity did not influence the concentration of fibronectin.(ABSTRACT TRUNCATED AT 250 WORDS)
血浆纤维连接蛋白被认为在抗感染抵抗力降低中起重要作用。为明确纤维连接蛋白在造血功能低下患者感染性并发症发病机制中的作用,采用酶联免疫吸附测定法(ELISA)检测了113例不同类型成血病、淋巴增殖性疾病及再生障碍综合征患者的该调理素含量。42例患者在合并不同严重程度感染时测定了调理素浓度。对39例患者在细胞毒性联合化疗前、化疗期间及化疗后检测了纤维连接蛋白含量。结果发现,在副蛋白血症性成血病、淋巴肉芽肿病、再生障碍性贫血、慢性淋巴细胞白血病、急性淋巴细胞和髓(单核)细胞白血病、周期性中性粒细胞减少症、慢性粒细胞增多症及血液肉瘤患者中,在无感染时纤维连接蛋白浓度保持正常。计算线性相关系数未发现调理素水平与外周血中肿瘤细胞浓度之间存在任何关联。对基础疾病伴有明显肿瘤热的患者反复测量纤维连接蛋白水平,未发现该糖蛋白有任何缺乏。在患有严重败血症、坏死性肠病和大叶性肺炎等合并感染的患者中记录到纤维连接蛋白水平降低。调理素缺乏程度与患者疾病严重程度相关。血液中纤维连接蛋白水平长期降低具有不良预后意义。细胞毒性联合化疗、骨髓毒性粒细胞缺乏症以及轻度感染性并发症均未影响纤维连接蛋白浓度。(摘要截短于250字)