- 作者: 李錦發; 朱炳圻; 鄭淑珠; 羅勃古德; 傅茂祖; 壽廉
- 作者服務機構: 國防醫學院內科學系;三軍總醫院內科部; 國防醫學院微生物暨免疫學系; 美國俄克拉荷馬醫學研究基金會
- 中文摘要: 感染症是糖尿病常見的一種併發症,過去許多研究顯示糖尿病患者體內的抗菌機轉有所缺陷,包括白血球的趨化、吞噬及殺菌作用等。吞噬作用進行時,吞噬細胞須先與病原體發生附著作用才能激發細胞膜,進而吞飲病原體。一般而言,病原體須經抗體與補體的調理作用後,才能直接與吞噬細胞的Fc及C3b接受器發生反應,最後再被吞噬。糖的代謝障礙與此等接受器的關係至今尚未見良好的研究,本論文利用EA及EAC玫瑰結的技術,測定22位無併發感染症但血糖控制不良糖尿病患者,及14位正常對照者吞噬細胞表面Fc及C3b接受器。 結果發現糖尿病患者周邊血液的多核形白血球的Fc及C3b接受器分別是79.4 ± 8.2%及65.5 ± 17.6%,與正常對照組之78.4 ± 14.7%及73.8 ± 10.9%無顯著差別。周邊單核球Fc接受器亦相仿,病人及正常人分別為66.0 ± 9.4%及72.5 ± 9.3%,無統計學上的意義,但單核球細胞膜表面的C3b接受器病人為 48.3 ± 15.2%,而正常人則為68.1 ± 8.2%,P<0.001。如用胰島素(1000 μunit/ml)與患者單核球做體外培養1小時後,其單核球C3b接受器可提升至67.8 ± 17.5%,幾近正常。另一方面,如將正常人單核球置入含有20%糖尿病患者血清之組織培養液中培養1小時後,其C3b接受器有顯著的下降(P<0.01)。反之,正常人的血清則可使糖尿病患者單核球的C3b接受器回復至正常水準。如將正常人單核球在含高濃度葡萄糖(500 mg/100 ml)溶液中培養1小時後,其C3b接受器數目未顯示改變。
- 英文摘要: Attachment, an energy-independent step, of sensitized sheep erythrocytes EA and EAC to Fc andC3b receptors, respectively, on granulocytes and monocytes from poorly controlled diabetic patients wasinvestigated. The results show similar percentages of EA and EAC rosette-forming cells for normal anddiabetic human neutrophils. The expression of Fc receptors on normal and diabetic monocytes were alsosimilar in that the former contained 74.5 ± 9.3% and the latter contained 66.0 ± 9.4% rosette-forming cells.However, a significantly lower percentage (48.3 ± 15.2%) of EAC rosette positive cells was found in diabeticmonocytes as compared to that (68.1 ± 8.2%) found in normal controls (p<0.001). Incubation of diabeticmonocytes with insulin or serum obtained from normal individuals one hour prior to assay corrected theimpaired expression of C3b receptors in diabetic monocytes. In addition, we also found that diabetic serumitself is noxious to C3b receptor expression by normal human monocytes and that high concentrations ofglucose play no apparent role in the regulation of the receptor function.
- 中文關鍵字: Fc and C3b receptors; glucose; insulin; serum; diabetes
- 英文關鍵字: --