- 著者
-
三須 俊宏
Toshihiro Misu
獨協医科大学越谷病院耳鼻咽喉科
Department of Otorhinolaryngorogy Koshigaya Hospital Dokkyo University School of Medicine
- 雑誌
- Dokkyo journal of medical sciences (ISSN:03855023)
- 巻号頁・発行日
- vol.31, no.1, pp.57-63, 2004-03-25
好酸球類粒蛋白の一つであるECPは,気道上皮障害を引き起こす事が知られている.血清ECPは,喘息や鼻アレルギー症状の重篤度を,反映していると報告されているが,血漿ECPは,血清ECPに比べ,常に低値となる.その値の違いが生じる理由を解明するため,アレルギー性鼻炎の症例を対象にして,検討した.患者血液を3種類の試験管に採血した.血液凝固剤入り,抗血液凝固剤入り,無添加の3種類である.その結果,血清ECPは,血漿ECPに比べ,常に高値を示した.しかも凝固剤を入れた血清ECPの方が無添加の血清ECPより高値であった.血清採取後の血餅中に存在する好酸球は,細胞膜が破綻し,顆粒の空胞化も顕著であった.一方,血漿採取時に生じたbuffy coat中の好酸球は,正常な形態を示すものが,大部分であった. ECP値は,好酸球細胞膜の破綻程度と有意な相関を示した.空胞化した顆粒を待った好酸球の細胞膜が破綻した時は,更なるECP高値を示した.以上の結果よりECPは,採血後に好酸球が,血餅という物理的な圧迫を受け,細胞崩壊をきたし,放出されるものと思われた.従って血清ECPは,好酸球の崩壊しやすさを,測定しているものであると思われた.ECP is one of the basic proteins in eosinophil granules. It is known that the serum ECP reflects well the seriousness of asthma and nasal allergy. But ECP does not exist in the blood stream. It is detected in the blood serum preserved in the test tube for one hour, especially with blood coagulant. Only a small amount of ECP is detected in the blood plasma. One hour after blood collection, the blood was centrifuged and ECP in serum and blood plasma was measured by radioimmunoassay. The eosinophils in cruor and buffy coat were observed by electron microscope. Ten to fifteen eosinophils in each test tube were observed. The value multiplied the factor of the destruction of the cell membrane by the factor of the vacuole change of the granules was defined as destruction index. The highest ECP value was detected in serum with blood coagulant, the lowest ECP value was in blood plasma and middle value was in serum with additive free (p = 0.0063). Most eosinophils in buffy coat had intact cell membrane, but many eosinophils in cruor were destroyed. The degree of the destruction of the cell membrane and the destruction index showed the significant difference in 3 groups. The ECP value (ECP/Eosinos) showed the significant correlation both with the degree of destruction of the cell membrane (p = 0.0030) and the destruction index (p = 0.0021). It is concluded that ECP in serum was released from destroyed eosinophils in test tube during clot formation after the blood collection. It is considered that the eosinophils compressed in clot formation cause destruction. Therefore, the level of serum ECP indicates the easiness of eosinophil destruction.