組織蛋白酶B與其抑制劑胱蛋白C在慢性阻塞性肺疾病的變化

Changes of Cathepsin B and Cystatin C levels in Chronic Obstructive Pulmonary Disease

楊國坤(Kok-Khun, Yong)

指導教授 ： 曹昌堯 ； 楊順發

中山醫學大學/醫學院/醫學研究所/碩士(2011年)

https://doi.org/10.6834/CSMU.2011.00157

摘要

我們擬探討血漿中的發炎性蛋白，組織蛋白酶B及其抑制劑胱蛋白C在慢性阻塞性肺疾病（COPD）患者在急性發作時、急性發作兩週後及急性發作八週後的表現情況。並進一步觀察這些發炎性指標與慢性阻塞性肺病發炎過程的相關性。因此，我們收集了四十六位慢性阻塞性肺病患者，包括44男2女，均來自於埔里基督教醫院。我們在三個不同的時期，即急性發作期間、急性發作兩週後及急性發作八週後收集其血漿。另外，我們收集一次共十八名健康受試者，包括10男8女的血漿作為我們實驗的對照組。我們利用酵素連結免疫分析法（ELISA）來分析我們所指定的血清蛋白。結果發現慢性阻塞性肺病患者的血漿組織蛋白酶B水平在急性發作兩週後和急性發作八週後明顯高於對照組。然而組織蛋白酶B數值在COPD患者治療兩週後明顯高於急性發作時。胱蛋白C的數值在COPD患者也是明顯高於對照組。此外，COPD患者的CRP值及絕對嗜中性白血球的數值都明顯高於對照組。因此我們發現COPD患者的胱蛋白C數值都偏高，也許是因為長期慢性炎症反應所呈現出來為一種代償性的機制。再者，我們認為組織蛋白酶B在慢性阻塞性肺病急性發作時可能也是代表一種急性期反應蛋白的其中之一。

關鍵字

組織蛋白酶B ； 胱蛋白C ； 慢性阻塞性肺疾病

並列摘要

Plasma levels of inflammatory protein, cathepsin B and its naturally inhibitory protein cystatin C were examined in chronic obstructive pulmonary disease (COPD) patients during and two weeks as well as 8 weeks after acute exacerbation (AE). The changes of of plasma levels of these proteins were evaluated to speculate whether they are well correlated with the inflammatory statuses of COPD exacerbation. Forty six COPD patients, including 44 male and 2 female, were included in this study. All of the patients were treated at Puli Christian Hospital, a regional teaching hospital at Taiwan. Plasma were collected in three different times, i.e., during, and 2 weeks as well as 8 weeks after AE. Eighteen healthy subjects, including 10 male and 8 female, were studied as control. Their plasma were collected once on enrollment. Enzyme-linked immunosorbent assay(ELISA) wad use to measured the plasma levels of the study proteins. The plasma levels of cathepsin B were significantly higher in COPD patients at 2 weeks and 8 weeks after AE when compared with those of healthy subjects. In COPD patients, the plasma levels of cathepsin B were significantly higher at 2 weeks after AE than those at the time of AE. The plasma level of cystatin C showed significantly higher than the plasma levels of healthy subjects at time of AE, also 2 weeks and 8 weeks after AE. However, there was no significant difference between the time of AE and 2 or 8 weeks after AE. Besides, there were significantly increased plasma levels of C reactive protein (CRP) and peripheral blood neutrophil counts in COPD patients when compared with those of healthy subjects. In conclusions, the persistently significant higher plasma levels of cystatin C in COPD patients not only on AE but also at 2 and 8 weeks after AE than those in healthy subjects might represent a chronic inflammatory status in COPD. However, plasma level of cathepsin B significantly increased at 2 weeks after AE and which returned to be non-significant at 8 weeks after AE in COPD patients. These findings might hint cathepsin B is one of the acute phase reactive protein in AE of COPD.

並列關鍵字

cathepsin B ； cystatin C ； chronic obstructive pulmonary disease

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