Wegener肉芽腫の病因・病態に関する研究（II）—好中球の殺菌能について

ETIOLOGY AND SYNIPTONIS OF WEGENER'S GRANU-LONIA (Ⅱ): THE BACTERIOCIDAL ACTIVITY OF NEUTROCYTES

　I．はじめに

　Wegener肉芽腫は初期病変である鼻腔，上気道の壊死性肉芽性病変は炎症所見が強いが抗生物質は無効である。

　炎症性肉芽性病変が治癒傾向を示さず漸次進展していく経過および赤沈値の亢進，CRPの強陽性，RAの陽性，Ig，IgG，IgAの亢進，血漿フィブリノーゲン値の亢進，血清補体価の亢進^1）2），ツ反応の陰性化などの検査成績の特徴はWegener肉芽腫が膠原病あるいは自己免疫疾患に近い病態であることを考えさせるが，その本態はなお不明である。

　Recently the nitroblue tetrazolium (NBT) reduction test, which was first devised by Park et al and is an indirect test for the bacteriocidal activity of the leucocytes, has been widely used for the diagnosis of chronic granulomatous diseases, and also for the differential diagnosis of infectious diseases.

　With a modified method, the leucocytes from patients with Wegener's granulomatosis were examined.

　The results were as follows. 1) In spontaneous NBT test no dilfiTence in scores was found between Wegener's granulomatosis patients (0-10%) and normal controls (0-11%). However, when the patients with Wegener's granulomatosis were devided into the treated and untreated group, the treated group showed significantly low scores and the untreated group showed the scores as high as of the control group. 2) The stimulated NBT reduction test with latex particle revealed the similar results with the spontaneous NBT reduction test. 3) Another stimulated NBT reduction test, using lipopolysaccharides from E. coli as a stimulant, gave significantly higher scores in all the groups than the spontaneous NBT reduction test. The untreated group was found more sensitive to the stimulants than the control group. This fact may explain that the bacteriocidal activity of leucocyte of the patients is not disturbed, but sometimes elevated by the special stimulants.