Clinical and Experimental Pediatrics

대한소아청소년과학회 (The Korean Pediatric Society)
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소아의 전염성 단핵구증에서 사이토카인과 세포자멸사 연관 유전자의 발현의 변화

Changes in the expression of cytokines and apoptosis-related genes in children with infectious mononucleosis

  • 조대선 (전북대학교 의과대학 소아과학교실) ;
  • 한지혜 (전북대학교 의과대학 소아과학교실) ;
  • 김선영 (전북대학교 임상의학연구소) ;
  • 김민선 (전북대학교 의과대학 소아과학교실) ;
  • 이호근 (전북대학교 치과대학 생화학교실) ;
  • 이대열 (전북대학교 의과대학 소아과학교실) ;
  • 황평한 (전북대학교 의과대학 소아과학교실)
  • Jo, Dae Sun (Department of Pediatrics, Medical School, Chonbuk National University) ;
  • Han, Ji Hye (Department of Pediatrics, Medical School, Chonbuk National University) ;
  • Kim, Sun Young (Research Institute of Clinical Medicine, Chonbuk National University) ;
  • Kim, Min Sun (Department of Pediatrics, Medical School, Chonbuk National University) ;
  • Yi, Ho Keun (Department of Biochemistry, School of Dentistry, Chonbuk National University) ;
  • Lee, Dae-Yeol (Department of Pediatrics, Medical School, Chonbuk National University) ;
  • Hwang, Pyoung Han (Department of Pediatrics, Medical School, Chonbuk National University)
  • 투고 : 2009.07.13
  • 심사 : 2009.09.25
  • 발행 : 2009.12.15
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초록

목 적:소아 전염성 단핵구증 환자의 임상적 특성과 EBV 감염과 관련된 사이토카인과 세포자멸사 연관 유전자의 발현에 대해 알아보고자 본 연구를 시행하였다. 방 법:2006년 3월부터 2007년 2월까지 전북대학교병원에 입원한 전형적인 임상 증상을 보이면서 혈청학적 검사로 전염성 단핵구증으로 확진된 15명을 대상으로 임상적 특성을 조사하고, 진단 당시, 발병 1주 후, 3주 후에 각각 말초혈액에서의 T세포 세군, 사이토카인, EBV DNA, 세포자멸사 연관 유전자 발현을 측정하여 건강한 대조군 10명과 비교하였다. 결 과:환자의 평균 연령은 $5.7{\pm}3.4$세(3-9세)였으며, 남녀비는 1.5:1이었다. 발열(100%)과 인두통(73%), 무기력과 권태감(53%)이 흔한 임상 증상이었고, 인두염 및 편도염(100%), 경부 림프절 비대(87%)와 간비종대(53%)가 흔하게 나타났다. 환자의 말초혈액에서 CD3+ T세포와 CD8+ suppressor T세포, CD56+ NK세포가 대조군에 비하여 증가하였다(P<0.01). 환자의 혈청 IL-2, 6, $INF-{\gamma}$가 증상 초기에 대조군에 비하여 증가하였다(P<0.01). 환자의 말초혈액 단핵구내 EBV DNA 양은 평균 $10^{2.38}copies/{\mu}g$이었으며 진단 당시 최고치를 보이다가 회복기에는 정상화되는 양상이었다. 환자의 말초혈액 단핵구의 세포자멸사 연관 유전자 발현은 Bcl-2는 증상 초기에 증가하다가 감소하였고 Bax는 회복기에 약간 증가하였으며, Fas는 거의 변화가 없었으나 FasL은 발병 1주 후에 현저히 증가하였다가 회복기에 감소하였다. 결 론:본 연구를 통해 급성 전염성 단핵구증 소아 환자에서 다양한 임상 증상과 말초혈액에서 T세포 세군의 변화 및 세포자멸사 연관 유전자 발현의 변화를 확인하였다. 앞으로 분자 생물학적 관점에서의 병인 및 치료 방법에 대한 더 많은 연구가 필요할 것으로 사료된다.

Purpose:The aims of this study were to identify the clinical characteristics and determine the changes in the expression of cytokines and apoptosis-related genes in children with infectious mononucleosis. Methods:Serological examinations of 15 pediatric patients diagnosed with infectious mononucleosis were performed prospectively. Peripheral blood from the patients was used to compare the composition of T cell subsets, cytokines, Epstein-Barr virus (EBV) DNA, and the expression of apoptosis-related genes with those in 10 healthy children. Results:Mean age of the patient group was $5.7{\pm}3.4$ (range, 3-9) years, and the male-to-female ratio was 1.5:1. Fever, sore throat, pharyngitis/tonsillitis, and cervical lymph node enlargement were the most common symptoms and signs. The proportions of CD3+ T cells, CD8+ suppressor cells, and CD56+ natural killer (NK) cells were higher in the patient group than in the control group (P<0.01). The IL-2, IL-6, and interferon $(INF)-{\gamma}$ levels were higher in the early symptomatic period (P<0.01). Mean amount of EBV DNA in the patients was $10^{2.38}copies/{\mu}g$, and the amount was the highest at the beginning of the symptomatic period and normalized during the convalescent phase. Bcl-2 expression increased during the initial phase, while Bax expression increased during the convalescent phase. Further, FasL expression increased 1 week after symptom presentation and decreased during the convalescent phase. There was no significant change in Fas expression. Conclusion:We analyzed the clinical characteristics and changes in the expression ofcytokines and apoptosis-related genes in the patients with infectious mononucleosis.

키워드

과제정보

연구 과제 주관 기관 : Research Institute of Clinical Medicine, Chonbuk National University Hospital

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피인용 문헌

  1. Plasma Real Time-Quantitative Polymerase Chain Reaction of Epstein-Barr Virus in Immunocompetent Patients with Hepatitis vol.15, pp.1, 2012, https://doi.org/10.5223/kjpgn.2012.15.1.38