Samsonov M Y, Tilz G P, Pisklakov V P, Reibnegger G, Nassonov E L, Nassonova V A, Wachter H, Fuchs D
National Cardiology Research Center, Moscow, Russia.
Clin Immunol Immunopathol. 1995 Jan;74(1):31-4. doi: 10.1006/clin.1995.1005.
Immune activation may play an important role in the pathogenesis of acute rheumatic fever (ARF). The objective of the present study was to investigate serum concentrations of various markers of immune activation in ARF patients. Sera of 32 patients with ARF were investigated, 20 of them in follow-up. Radioimmunoassay was used to quantify neopterin and ELISA for the measurement of 55-kDa-type soluble tumor necrosis factor receptor (sTNF-R) and soluble interleukin-2 receptor (sIL2-R). Markers of immune activation were found to be raised in 48% (sTNF-R), 28% (sIL2-R), and 78% (neopterin) of patients at the onset of ARF. There were significant correlations between the concentrations of neopterin and sTNF-R (rs = 0.60, P < 0.001) or sIL2-R (rs = 0.35, P < 0.05). Higher neopterin concentrations were found in patients with combined aortic and mitral insufficiency than in patients with mitral valve lesions alone (U = 2.67, P < 0.05) or without valve lesion (U = 2.36, P < 0.05). Increased concentrations of neopterin, sTNF-R, and sIL2-R demonstrate activation of the cellular immune system in patients with ARF. Higher serum neopterin concentrations are associated with development of combined aortic and mitral insufficiency during the first episode of ARF.
免疫激活可能在急性风湿热（ARF）的发病机制中起重要作用。本研究的目的是调查ARF患者血清中各种免疫激活标志物的浓度。对32例ARF患者的血清进行了研究，其中20例进行了随访。采用放射免疫分析法对新蝶呤进行定量，采用酶联免疫吸附测定法检测55 kDa型可溶性肿瘤坏死因子受体（sTNF-R）和可溶性白细胞介素-2受体（sIL2-R）。发现ARF发病时，48%（sTNF-R）、28%（sIL2-R）和78%（新蝶呤）的患者免疫激活标志物升高。新蝶呤浓度与sTNF-R（rs = 0.60，P < 0.001）或sIL2-R（rs = 0.35，P < 0.05）浓度之间存在显著相关性。合并主动脉瓣和二尖瓣关闭不全的患者新蝶呤浓度高于单纯二尖瓣病变患者（U = 2.67，P < 0.05）或无瓣膜病变患者（U = 2.36，P < 0.05）。新蝶呤、sTNF-R和sIL2-R浓度升高表明ARF患者细胞免疫系统被激活。较高的血清新蝶呤浓度与ARF首次发作时合并主动脉瓣和二尖瓣关闭不全的发生有关。
