Tuberculosis and Respiratory Diseases

  • 제66권3호
  • /
  • Pages.205-210
  • /
  • 2009
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  • 1738-3536(pISSN)
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  • 2005-6184(eISSN)
대한결핵및호흡기학회 (The Korean Academy of Tuberculosis and Respiratory Diseases)
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타 폐질환과 비교를 통한 활동성 결핵에서 혈중 CXCL10과 CXCL11 증가의 의의

Preliminary Study for Elevated Serum CXCL10 and CXCL11 in Active Pulmonary Tuberculosis Compared with the Other Pulmonary Diseases

  • 박미영 (부산대학교 의학전문대학원 진단검사의학교실) ;
  • 김신영 (부산대학교 의학전문대학원 진단검사의학교실) ;
  • 황상현 (부산대학교 의학전문대학원 진단검사의학교실) ;
  • 김지은 (부산대학교 의학전문대학원 내과학교실) ;
  • 이민기 (부산대학교 의학전문대학원 내과학교실) ;
  • 이창훈 (부산대학교 의학전문대학원 병리학교실) ;
  • 이은엽 (부산대학교 의학전문대학원 진단검사의학교실)
  • Park, Mi Young (Department of Laboratory Medicine, School of Medicine, Pusan National University) ;
  • Kim, Shine Young (Department of Laboratory Medicine, School of Medicine, Pusan National University) ;
  • Hwang, Sang-Hyun (Department of Laboratory Medicine, School of Medicine, Pusan National University) ;
  • Kim, Ji-Eun (Department of Internal Medicine, School of Medicine, Pusan National University) ;
  • Lee, Min Ki (Department of Internal Medicine, School of Medicine, Pusan National University) ;
  • Lee, Chang-Hun (Department of Pathology, School of Medicine, Pusan National University) ;
  • Lee, Eun-Yup (Department of Laboratory Medicine, School of Medicine, Pusan National University)
  • 투고 : 2009.01.19
  • 심사 : 2009.03.09
  • 발행 : 2009.03.30
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초록

연구배경: CXCR3 리간드인 케모카인 CXCL10과 CXCL11은 세포면역 활성 시 interferon-$\gamma$에 의해 발현이 유도되어, T 림프구와 자연살생세포의 소집 및 활성도를 증가시키고 폐 감염 시 활성화된 기관지 상피 세포에서도 발현된다. 이에 저자들은 세포면역을 활성화 시킬 수 있는 폐암과 결핵감염에서의 CXCL11의 표현을 CXCL10과 함께 정량적으로 비교하여 활동성 결핵감염의 표지자로서 활용 가능성을 알아보고자 하였다. 방법: 2007년 1월부터 12월까지 부산대학교병원 호흡기 내과를 방문한 신규환자 중 폐암과 결핵이 의심되는 환자를 대상으로 전향적 연구를 시행하였다. 환자는 조직학적 그리고 임상적으로 47명의 폐암군, 18명의 활동성 폐결핵군, 그리고 대조군으로 38명의 양성폐질환군으로 분류하였다. 혈청에서 CXCL10과 CXCL11의 농도는 효소면역측정법을 이용하여 측정하였다. 결 과: CXCL10과 CXCL11은 활동성 폐결핵군에서 폐암군과 양성폐질환군에 비해 유의하게 증가되었다(p<0.001, Kruskal-Wallis). CXCL11은 폐암군이 양성 폐질환군에 비해 유의하게 높았으나, CXCL10은 차이가 없었다(각각, p<0.001, p=0.655, Mann-Whitney U). 폐암군에서 CXCL10은 stage III+IV군에서 stage I+II군에 비해 높았지만, CXCL11은 병기에 따른 유의한 차이를 보이지 않았다(p<0.001, p=0.07, Mann-Whitney U). 폐암의 전이 유무에서는 CXCL10과 CXCL11 모두 유의한 차이를 보이지 않았다. CXCL10과 CXCL11간에는 서로 유의한 상관관계가 있었다(r=0.223, p<0.001). 결 론: CXCL10과 CXCL11은 폐암을 포함한 타 폐질환에 비해 활동성 폐결핵에서 유의하게 증가되었다. 따라서, 활동성 폐결핵에 기존의 진단법과 함께 유용한 지표로서 사용될 수 있을 것이다.

Background: CXCL10 and CXCL11, which are family of CXCR3 ligands, are expressed by lymphocytes and even by bronchial epithelial cells if the cellular immunity is activated. This study evaluated the potential utility of CXCL10 and CXCL11 in the serum for active pulmonary tuberculosis in comparison with lung cancer, which activates the cellular immunity, and benign lung diseases. Methods: Patients who newly visited Pusan National University Hospital from January 2007 to December 2007 and were suspected of having lung cancer or tuberculosis were enrolled prospectively. The patients were classified pathologically and clinically into three groups, 47 with lung cancer, 18 with active pulmonary tuberculosis and 38 control patients with benign pulmonary disease. ELISA was used to determine the levels of CXCL10 and CXCL11 were determined in the serum. Results: The level of CXCL10 and CXCL11 were significantly higher in the active pulmonary tuberculosis group than in the lung cancer and benign lung disease groups (p<0.001, Kruskal-Wallis). The level of CXCL11 was significantly higher in the lung cancer group than in the benign pulmonary disease group, but there was no significant difference in level of CXCL10 between the three groups (p<0.001, p=0.655, respectively, Mann-Whitney U). The level of CXCL10 in patients with stage III+IV lung cancer was significantly higher than those with stage I+II, but there was no significant difference in the level of CXCL11 between the groups (p<0.001, p=0.07, respectively, Mann-Whitney U). There was no significant difference in the level of CXCL10 and CXCL11 between those with the presence and absence of lung cancer metastasis. There was a significant correlation between the level of CXCL10 and CXCL11 (r=0.223, p<0.001). Conclusion: CXCL10 and CXCL11 may be a potential useful markers for active pulmonary tuberculosis if used alongside other diagnostic methods.

키워드

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피인용 문헌

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