LEVELS OF PLATELET CALMODULIN FOR THE PREDICTION OF PROGRESSION AND SEVERITY OF ADOLESCENT IDIOPATHIC SCOLIOSIS
LEVELS OF PLATELET CALMODULIN FOR THE PREDICTION OF PROGRESSION AND SEVERITY OF ADOLESCENT IDIOPATHIC SCOLIOSIS
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DOI：
10.2106/00004623-199408000-00009
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发表时间：
1994-08-01
影响因子：
5.3
通讯作者：
AKMAKJIAN, J
中科院分区：
文献类型：
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作者：
KINDSFATER, K;LOWE, T;AKMAKJIAN, J
钙调素是一种钙结合受体蛋白，调节骨骼肌和血小板的收缩蛋白系统。测量27名青少年的血小板钙调素水平，以确定这些水平与特发性脊柱侧凸的进展或严重程度之间是否存在关系。这项研究包括17名患有不同严重程度和类型的特发性脊柱侧凸的患者，以及10名年龄和性别匹配的受试者组成的对照组：8名因非脊柱侧凸相关问题接受治疗的患者和2名正常志愿者。将血小板匀浆并离心，分离含钙调素的上清液。然后使用放射免疫测定法测量钙调蛋白的水平，结果表明，血小板钙调素水平呈进行性曲线者，（过去12个月内进步超过10个学位）（每微克蛋白质3.83纳克）显著高于曲线稳定的患者的水平（在过去12个月内进步不到5级）（每微克蛋白质0.60纳克）（P < 0.01）;稳定组和对照组血小板钙调素水平似乎是一个独立的，可能比单独的Risser征更急性的曲线进展的预测。在Risser征为0或1和进行性曲线的患者中，血小板钙调素的平均水平为4.42纳克/微克蛋白质，而在Risser征为0或1和稳定曲线的患者中，血小板钙调素的平均水平为0.69纳克/微克蛋白质，而在Risser征为2和5之间的患者中，血小板钙调素的平均水平为0.65纳克/微克蛋白质。血小板钙调素水平的单一测定并不能预测脊柱的弯曲程度（Pearson相关系数，r = 0.30）。临床相关性：血小板钙调素水平似乎是青少年特发性脊柱侧凸患者弯曲进展的一个有用的预测因子。如果未来的纵向研究证实了我们的结果，这些水平可以在临床上用于避免对曲线进展风险较低的患者进行不必要的照射，并更准确地预测是否需要使用支具或手术干预进行管理，或两者兼而有之。对于进展风险较高的患者。
Calmodulin is a calcium-binding receptor protein that regulates the contractile protein systems of skeletal muscle and platelets. The levels of platelet calmodulin were measured in twenty-seven adolescents to determine whether there was a relationship between these levels and the progression or the severity of idiopathic scoliosis. The study included seventeen patients who had idiopathic scoliosis of varying severity and patterns and a control group consisting of ten age and sex-matched subjects: eight patients who were being managed for non-scoliosis-related problems and two normal volunteers.Platelets were isolated from the venous blood of all adolescents. The platelets were homogenized and centrifuged, and the calmodulin-containing supernatant was isolated. The level of calmodulin was then measured with use of a radioimmunoassay that employs competitive binding between native, unlabeled calmodulin and I-125-labeled calmodulin.The results showed that the level of platelet calmodulin in the patients who had a progressive curve (more than 10 degrees of progression in the previous twelve months) (3.83 nanograms per microgram of protein) was significantly higher than the level in the patients who had a stable curve (less than 5 degrees of progression in the previous twelve months) (0.60 nanogram per microgram of protein) (p < 0.01); the levels in the stable group and the control group (0.69 nanogram per microgram of protein) were similar.The level of platelet calmodulin appeared to be an independent and possibly more acute predictor of progression of the curve than the Risser sign alone. In the patients who had a Risser sign of 0 or 1 and a progressive curve, the average level of platelet calmodulin was 4.42 nanograms per microgram of protein, compared with 0.69 nanogram per microgram of protein in the patients who had a Risser sign of 0 or 1 and a stable curve and 0.65 nanogram per microgram of protein in those who had a Risser sign of between 2 and 5. A single determination of the level of platelet calmodulin did not predict the degree of curvature of the spine (Pearson correlation coefficient, r = 0.30).CLINICAL RELEVANCE: The level of platelet calmodulin appears to be a useful predictor of progression of the curve in patients who have adolescent idiopathic scoliosis. If future longitudinal studies corroborate our results, these levels could be used clinically to avoid unnecessary irradiation in patients who have a low risk of progression of the curve and to predict more accurately the need for management with a brace or operative intervention, or both, in patients who have a high risk of progression.