Furukawa S, Matsubara T, Umezawa Y, Okumura K, Yabuta K
Department of Pediatrics, Yamaguchi University School of Medicine, Japan.
J Pediatr. 1994 May;124(5 Pt 1):721-5. doi: 10.1016/s0022-3476(05)81361-7.
To evaluate the role of tumor necrosis factor alpha (TNF-alpha) during acute Kawasaki disease, we measured p60 soluble tumor necrosis factor receptor (sT-NF-R) shedding into the circulation in 48 patients with acute Kawasaki disease, all of whom received intravenous infusions of gamma-globulin. Of the 48 patients, 5 had coronary artery lesions. Serum concentrations of p60 sTNF-R and TNF-alpha were measured by a sandwich enzyme immunoassay. Patients with Kawasaki disease had increased serum levels of p60 sTNF-R. We found a positive correlation between serum levels of p60 sTNF-R and levels of TNF alpha during acute Kawasaki disease. Moreover, patients with coronary artery lesions had higher levels of sTNF-R than did those without coronary artery lesions. Our findings indicate that p60 sTNF-R levels in serum may be useful for determining the severity of vascular damage during acute Kawasaki disease, and that patients with Kawasaki disease and high sTNF-R levels seem to be susceptible to coronary artery lesions even if they receive therapy with intravenous infusions of gamma-globulin.
为评估肿瘤坏死因子α（TNF-α）在急性川崎病中的作用，我们检测了48例急性川崎病患者循环中p60可溶性肿瘤坏死因子受体（sTNF-R）的释放情况，所有患者均接受了静脉注射丙种球蛋白治疗。48例患者中，5例有冠状动脉病变。采用夹心酶免疫测定法检测血清中p60 sTNF-R和TNF-α的浓度。川崎病患者血清p60 sTNF-R水平升高。我们发现急性川崎病期间血清p60 sTNF-R水平与TNF-α水平呈正相关。此外，有冠状动脉病变的患者sTNF-R水平高于无冠状动脉病变的患者。我们的研究结果表明，血清中p60 sTNF-R水平可能有助于确定急性川崎病期间血管损伤的严重程度，并且即使接受静脉注射丙种球蛋白治疗，川崎病患者且sTNF-R水平高者似乎易患冠状动脉病变。
