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Activación del sistema de contacto en niños con vasculitis
Robin Kahn1, Heiko Herwald, Werner Müller-Esterl
1Department of Paediatrics, Lund University, Lund, Sweden.
Lancet (London, England)
|September 21, 2002
Resumen
Los niños con vasculitis muestran activación del sistema de contacto, indicado por el aumento de los niveles de bradicinina. Esto sugiere que el sistema de contacto juega un papel en la patogénesis de la vasculitis y síntomas como inflamación e hinchazón.
Área de la Ciencia:
- Inmunología Inmunología.
- Fisiopatología Fisiopatología.
- La pediatría es la medicina de los niños.
Sus antecedentes:
- El sistema de contacto inicia la cascada de kallikrein-kinin, liberando bradykinin. que también se encuentra en el sistema de contacto.
- Los componentes del sistema de contacto poseen propiedades proinflamatorias y vasoactivas.
- La vasculitis implica inflamación de la pared de los vasos con mecanismos moleculares poco conocidos.
Objetivo del estudio:
- Para investigar la activación del sistema de contacto en pacientes pediátricos con vasculitis.
- Para explorar el vínculo entre la activación del sistema de contacto y los síntomas de vasculitis.
Principales métodos:
- Comparó a 17 niños con vasculitis con 21 controles sanos.
- Se analizó la proteólisis del quinógeno de alto peso molecular a través de la inmunoblotación.
- La bradicinina y la proteína de unión a la heparina (HBP) cuantificadas en plasma mediante ELISA; biopsias teñidas para las quininas.
Principales resultados:
- Se observó una extensa proteólisis de quinógeno de alto peso molecular en 13/17 pacientes frente a 1/21 controles (p<0.0001).
- Concentraciones plasmáticas de bradicinina significativamente más altas en los pacientes (mediana de 320 ng/L) frente a los controles (11 ng/L) (p=0.0004).
- Niveles elevados de HBP en pacientes (17,4 microg / L) frente a controles (6 microg / L) (p = 0,008); liberación local de quinina en tejidos inflamados.
Conclusiones:
- La activación del sistema de contacto está implicada en la patogénesis de la vasculitis.
- Esta activación puede explicar la inflamación, el dolor, la vasodilatación y el edema en pacientes con vasculitis.
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