Reimert C M, Ouma J H, Mwanje M T, Magak P, Poulsen L K, Vennervald B J, Christensen N O, Kharazmi A, Bendtzen K
Laboratory of Medical Allergology, National University Hospital, Copenhagen, Denmark.
Acta Trop. 1993 Jun;54(1):1-12. doi: 10.1016/0001-706x(93)90063-h.
The pre- and post-treatment level of eosinophiluria, as measured indirectly by the amount of free or cell bound eosinophil cationic protein (ECP) and eosinophil protein X (EPX) in urine from Schistosoma haematobium-infected Kenyan school children, were measured and compared with intensity of infection (eggs/10 ml of urine), albuminuria and pathological changes as detected by ultrasonography. ECP and EPX were determined by means of specific ELISA methods and levels were determined in both urine supernatants and extracted urine deposits (cells and cell debris). The level of ECP was significantly raised in urine supernatants from infected children compared to controls, whereas high amounts of EPX were found in urine supernatants from infected children as well as from controls. However, the amounts of cell bound ECP and EPX were significantly raised in infected children. In pre-treatment observations significant correlations were demonstrated between egg counts, albuminuria and eosinophiluria as measured by the amount of cell bound ECP and EPX, or ECP in urine supernatants. No such correlations were demonstrated with the amount of EPX in the urine supernatants. Comparable amounts of ECP and EPX could be extracted from the urine deposits from infected children, but due to the high amounts of EPX in urine deposit extracts from controls, extracted ECP gave the best discrimination between infected and non-infected children. While albuminuria disappeared in most children at the 6 week post-treatment follow-up, eosinophiluria persisted in a significant proportion of the treated children indicating continued eosinophil activity in the bladder wall. Detection and quantification of early acute inflammatory reactions using ECP/eosinophils in combination with detection of later stages of bladder pathology using ultrasound may allow for a dynamic evaluation of the pathological process, the morbidity development and post treatment pathological changes in S. haematobium infections.
通过测量感染埃及血吸虫的肯尼亚学龄儿童尿液中游离或细胞结合的嗜酸性粒细胞阳离子蛋白（ECP）和嗜酸性粒细胞蛋白X（EPX）的量，间接测定治疗前后的嗜酸性粒细胞尿水平，并将其与感染强度（每10毫升尿液中的虫卵数）、蛋白尿以及超声检查所发现的病理变化进行比较。采用特异性酶联免疫吸附测定（ELISA）方法测定ECP和EPX，并在尿液上清液和提取的尿沉渣（细胞和细胞碎片）中测定其水平。与对照组相比，感染儿童尿液上清液中的ECP水平显著升高，而在感染儿童以及对照组的尿液上清液中均发现大量的EPX。然而，感染儿童中细胞结合的ECP和EPX量显著升高。在治疗前的观察中，通过细胞结合的ECP和EPX或尿液上清液中的ECP量所测得的虫卵计数、蛋白尿和嗜酸性粒细胞尿之间显示出显著相关性。而尿液上清液中EPX的量未显示出此类相关性。可从感染儿童的尿沉渣中提取出相当数量的ECP和EPX，但由于对照组尿沉渣提取物中EPX含量较高，提取的ECP在区分感染儿童和未感染儿童方面表现最佳。虽然在治疗后6周的随访中，大多数儿童的蛋白尿消失，但相当比例的接受治疗儿童的嗜酸性粒细胞尿持续存在，这表明膀胱壁中嗜酸性粒细胞仍在持续活动。结合使用ECP/嗜酸性粒细胞检测早期急性炎症反应以及使用超声检测膀胱病理后期阶段，可能有助于动态评估埃及血吸虫感染的病理过程、发病率发展以及治疗后的病理变化。
