尿嗜酸性粒细胞衍生神经毒素/蛋白X：一种评估体内嗜酸性粒细胞脱颗粒的简单方法。

Urinary eosinophil-derived neurotoxin/protein X: a simple method for assessing eosinophil degranulation in vivo.

作者信息

Cottin V, Deviller P, Tardy F, Cordier J F

机构信息

Service de Pneumologie, Hôpital Cardiovasculaire et Pneumologique Louis Pradel, Université Claude Bernard, Lyon, France.

出版信息

J Allergy Clin Immunol. 1998 Jan;101(1 Pt 1):116-23. doi: 10.1016/S0091-6749(98)70202-7.

DOI:10.1016/S0091-6749(98)70202-7

PMID:9449510

Abstract

BACKGROUND

Eosinophil-derived neurotoxin/protein X (EDN/EPX), one of the cationic granule proteins released by polymorphonuclear eosinophils, can be detected in human urine.

OBJECTIVE

We sought to evaluate whether the urinary release of EDN/EPX was dependent on the blood eosinophil cell count, the bronchoalveolar eosinophil cell count, or both and on the clinical diagnosis. We also attempted to determine the precise kinetics of decrease of EDN excretion and eosinophil counts after the onset of corticosteroid treatment.

METHODS

Daily urinary release of EDN/EPX was measured by radioimmunoassay in 28 patients with high hypereosinophilia (group 1), 32 patients with moderate hypereosinophilia (group 2), 26 patients without hypereosinophilia at the time of the study but with a known pulmonary disease involving eosinophils (group 3), and 13 control patients (group 4).

RESULTS

The urinary excretion of EDN/EPX was significantly higher in patients from groups 1 or 2 than in patients from groups 3 or 4. Particularly high levels of EDN/EPX excretion were observed in patients from groups 1 or 2 with chronic eosinophilic pneumonia (chronic eosinophilic pneumonia: 4.7 +/- 8.1 mg/day, control subjects: 0.39 +/- 0.33 mg/day, p < 0.001). Urinary excretion of EDN/EPX was significantly correlated with blood (r = 0.66, p < 0.001) and differential bronchoalveolar (r = 0.62, p = 0.04) eosinophil cell counts in patients from group 1 but not from the other groups. Corticosteroid treatment was followed by a significant decrease in EDN/EPX excretion. The kinetics of decrease in EDN/EPX were delayed as compared with the dramatic drop in peripheral eosinophil counts. Distinct kinetics between urinary EDN/EPX and eosinophil counts differentiated the recurrence of chronic eosinophilic pneumonia from an asthma attack in one patient.

CONCLUSION

Measurement of urinary EDN/EPX excretion may be a useful indicator of eosinophil degranulation in vivo.

摘要

背景

嗜酸性粒细胞衍生神经毒素/蛋白X（EDN/EPX）是多形核嗜酸性粒细胞释放的阳离子颗粒蛋白之一，可在人尿液中检测到。

目的

我们试图评估EDN/EPX的尿排泄是否依赖于血液嗜酸性粒细胞计数、支气管肺泡嗜酸性粒细胞计数或两者，以及临床诊断。我们还试图确定皮质类固醇治疗开始后EDN排泄和嗜酸性粒细胞计数下降的精确动力学。

方法

通过放射免疫分析法测量28例高嗜酸性粒细胞增多症患者（第1组）、32例中度嗜酸性粒细胞增多症患者（第2组）、26例研究时无嗜酸性粒细胞增多症但患有已知嗜酸性粒细胞性肺部疾病的患者（第3组）和13例对照患者（第4组）的每日EDN/EPX尿排泄量。

结果

第1组或第2组患者的EDN/EPX尿排泄量显著高于第3组或第4组患者。在患有慢性嗜酸性粒细胞性肺炎的第1组或第2组患者中观察到特别高的EDN/EPX排泄水平（慢性嗜酸性粒细胞性肺炎：4.7±8.1mg/天，对照受试者：0.39±0.33mg/天，p<0.001）。第1组患者的EDN/EPX尿排泄量与血液嗜酸性粒细胞计数（r = 0.66，p<0.001）和支气管肺泡嗜酸性粒细胞分类计数（r = 0.62，p = 0.04）显著相关，而其他组患者则无此相关性。皮质类固醇治疗后，EDN/EPX排泄量显著下降。与外周嗜酸性粒细胞计数的急剧下降相比，EDN/EPX下降的动力学延迟。尿EDN/EPX和嗜酸性粒细胞计数之间的不同动力学区分了一名患者慢性嗜酸性粒细胞性肺炎的复发与哮喘发作。