■川崎病(KD)是一种与血管损伤和自身免疫反应相关的血管炎。炎症因子刺激嗜中性粒细胞产生网状结构,称为嗜中性粒细胞胞外陷阱(NETs)。瓜氨酸化组蛋白3(H3Cit)是参与NETosis过程的中性粒细胞胞外陷阱的主要蛋白成分之一。KD中NETs和H3Cit的水平未知。
■确定KD中NETs和H3Cit水平的变化。
■招募KD儿童,根据疾病阶段和是否使用静脉免疫球蛋白(IVIG)分为急性KD组和亚急性KD组。在IVIG给药前后取外周静脉血,并通过流式细胞术检查NETs。通过酶联免疫吸附测定(ELISA)测量H3Cit的水平。
■与健康对照组相比,急性KD组的NETs计数显着增加(p<0.01)。急性KD组的H3Cit水平明显高于健康对照组。值得注意的是,与急性KD组相比,IVIG治疗的KD患者的NETs计数和H3Cit水平均降低(p<0.01)。
■急性KD的特征在于NETs的形成增加和高水平的H3Cit。IVIG显着抑制了KD儿童的NETs形成,并降低了血浆H3Cit的水平。
Kawasaki disease (KD) is a vasculitis associated with vascular injury and autoimmune response. Inflammatory factors stimulate neutrophils to produce web-like structures called neutrophil extracellular traps (NETs). Citrullinated histone 3 (H3Cit) is one of the main protein components of neutrophil extracellular traps involved in the process of NETosis. The levels of NETs and H3Cit in the KD are not known.
To determine the changes in the levels of NETs and H3Cit in KD.
Children with KD were recruited and divided into the acute KD and the sub-acute KD group according to the disease phase and whether intravenous immunoglobulin (IVIG) was used or not. Peripheral venous blood was taken before and after the IVIG administration and sent for the examination of NETs by flow cytometry. The level of H3Cit was measured by enzyme-linked immunosorbent assay (ELISA).
The counts of NETs in the acute KD group significantly increased compared with the healthy controls (p<0.01). The level of H3Cit was significantly higher in the acute KD group than in the healthy control subjects. Of note, both the counts of NETs and the level of H3Cit decreased in the KD patients treated with IVIG compared with the acute KD group (p<0.01).
Acute KD is characterized by an increased formation of NETs and high levels of H3Cit. IVIG significantly inhibited NETs formation and also reduced the level of plasma H3Cit in children with KD.