ABNORMAL REGULATION OF INFLAMMATORY SKIN-RESPONSES IN MALE-PATIENTS WITH CHRONIC GRANULOMATOUS-DISEASE
ABNORMAL REGULATION OF INFLAMMATORY SKIN-RESPONSES IN MALE-PATIENTS WITH CHRONIC GRANULOMATOUS-DISEASE
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DOI：
10.1007/bf00917259
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发表时间：
1983-01-01
期刊：
影响因子：
5.1
通讯作者：
BUESCHER, ES
中科院分区：
文献类型：
--
作者：
GALLIN, JI;BUESCHER, ES
慢性肉芽肿病（CGD）患者对感染反应的一个共同特征是过度且长期的炎症反应，经常出现引流淋巴结和肉芽肿形成。最近有报道称，几名 CGD 患者的中性粒细胞趋化反应的细胞和体液成分存在轻微但显着的体外异常，这预示着对炎症刺激的反应减弱。因此，进行了以下研究来评估 CGD 患者的体内炎症反应。对 8 名 CGD 患者（5 名男性和 3 名女性）和 10 名志愿者进行了 24 小时的 Rebuck 皮窗手术。磨损后 1、3、5、8、12 和 24 小时更换窗户。皮肤窗的定量是在显微镜图像分析仪计算机设施的帮助下进行的。 CGD 患者在前 5 小时内中性粒细胞积聚到皮肤窗内是正常的。然而，在8至24小时期间，当中性粒细胞从正常炎症反应中特征性消失并被单核细胞取代时，男性CGD患者炎症灶处PMN异常持续存在，而女性CGD患者则不然（对于5名男性CGD和10名正常人从8小时到24小时PMN下降率的比较，P<0.05）。单核细胞募集正常。在一名 CGD 男性中，异常的皮肤窗口反应在接受白细胞输注时恢复正常。数据表明，男性 CGD 患者的急性炎症反应存在异常“关闭”，并支持氧化代谢产物对炎症反应的调节作用。此外，他们表明，中性粒细胞趋化性的轻微体外缺陷与体内抑制的急性炎症反应无关，因此不能解释CGD患者对某些感染的易感性增加。
A common characteristic of the response to infection seen in patients with chronic granulomatous disease (CGD) is an exaggerated and prolonged inflammatory response with frequent development of draining lymph nodes and granuloma formation. Recent reports of several CGD patients with minor but significant in vitro abnormalities of cellular and humoral components of neutrophil chemotactic responses would predict lessened responses to inflammatory stimuli. The following studies were, therefore, performed to assess in vivo inflammatory responses in patients with CGD. Twenty-four-hour Rebuck skin-window procedures were performed on eight patients (five male and three female) with CGD and on ten volunteers. The windows were changed 1, 3, 5,8, 12, and 24 h after the abrasion. Quantitation of the skin windows was performed with the assistance of a microscopeimage analyzer computer facility. Neutrophil accumulation into skin windows was normal in CGD patients throughout the first 5 h. However, during the 8-to 24-h period, when neutrophils characteristically disappear from normal inflammatory responses and are replaced by monocytes, there was abnormal persistence of PMN at the inflammatory foci in male but not in female CGD patients (P<0.05 for the comparison of the rates of decline of PMN, from hour 8 to hour 24, in five male CGDs and in 10 normals). Monocyte recruitment was normal. In one CGD male, the abnormal skin-window response was normalized while he was receiving white cell transfusions. The data indicate that there is an abnormal “turn off” of the acute inflammatory response in male CGD patients and support a modulatory role for products of oxidative metabolism on the inflammatory response. In addition, they indicate that the mild in vitro defect in neutrophil chemotaxis is not associated with a depressed, acute inflammatory response in vivo and, therefore, does not explain the increased susceptibility of CGD patients to certain infections.