产气荚膜梭菌α毒素在急性胰腺炎发病机制中的潜在作用。
The potential role of Clostridium perfringens alpha toxin in the pathogenesis of acute pancreatitis.
作者信息
Holdsworth R J, Parratt D
机构信息
Department of Surgery, Ninewells Hospital and Medical School, Dundee.
出版信息
J Clin Pathol. 1996 Jun;49(6):500-3. doi: 10.1136/jcp.49.6.500.
BACKGROUND
Clostridium perfringens is a bowel commensal that can colonise the biliary tract. It produces the alpha toxin (phospholipase C), which can induce spontaneous tissue necrosis.
AIMS
To investigate whether there is any evidence that Clostridium perfringens alpha toxin can be detected in acute pancreatitis.
METHODS
Serum samples from 21 patients with acute pancreatitis and 22 controls were assayed for C perfringens phospholipase C as well as anti-phospholipase C IgG and IgM; IgG and IgM anti-toxins were measured by enzyme linked immunosorbent assay.
RESULTS
In normal healthy controls there is a very high level of natural anti-toxin of both the IgG and IgM class. Of the 21 patients with acute pancreatitis alpha toxin was detected in five (23.8%). Levels of both IgG and IgM anti-toxin were significantly reduced in acute pancreatitis.
CONCLUSIONS
The results suggest that there is an abnormality of the immune status to C perfringens alpha toxin in patients with acute pancreatitis. This may be the result of a release of alpha toxin, although it is difficult to state whether this is a primary or secondary phenomenon in these patients. These preliminary results merit further investigation.
背景
产气荚膜梭菌是一种可定殖于胆道的肠道共生菌。它产生α毒素（磷脂酶C），可诱导自发性组织坏死。
目的
研究是否有证据表明急性胰腺炎患者中可检测到产气荚膜梭菌α毒素。
方法
检测21例急性胰腺炎患者和22例对照者的血清样本中的产气荚膜梭菌磷脂酶C以及抗磷脂酶C IgG和IgM；采用酶联免疫吸附测定法检测IgG和IgM抗毒素。
结果
在正常健康对照者中，IgG和IgM类天然抗毒素水平很高。21例急性胰腺炎患者中有5例（23.8%）检测到α毒素。急性胰腺炎患者的IgG和IgM抗毒素水平均显著降低。
结论
结果表明，急性胰腺炎患者对产气荚膜梭菌α毒素的免疫状态存在异常。这可能是α毒素释放的结果，尽管难以确定这在这些患者中是原发性还是继发性现象。这些初步结果值得进一步研究。
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