手足口病患儿血清细胞因子水平及其与病情的相关性

Levels of serum cytokines in children with hand-foot-and-mouth disease and their correlation with disease severity

目的探讨手足口病（HFMD）患儿血清细胞因子的水平及其与病情严重程度的相关性。方法病例组为住院HFMD患儿37例，均已确诊为肠道病毒感染，其中轻型病例21例，重症病例16例；对照组为本院同期唇腭裂治疗中心的先天性唇腭裂、非感染择期手术同龄患儿10例。应用液相芯片分析平台检测病毒阳性患儿的血清标本及对照组血清细胞因子[TNF—α、IL-1α、IL-1β、IL-2、IL-6、1L-8、IL-12亚单位P40（IL-12P40）、IL-12亚单位PTO（IL-12P20）、IFN-γ、IL-4、IL-10、1L-1β水平，并分析其与病情严重程度的相关性。结果1．重症组IFN-1、IL-10、IL-12P40、IL-1α、IL-1β、IL-4、IL-6、IL-8和TNF—α的表达水平均显著高于对照组（P均〈0．02）；重症组细胞因子INF-1和IL-2的表达水平均高于轻症组（P均〈0．02）；轻症组IL-10、IL-12P40、IL-1α、IL—1α、IL4、IL-6、IL-8和TNF-α均显著高于对照组（P均〈0，02）；轻症组IL-13和IL-12P70水平均低于对照组（P均〈0．02）。2．病情严重程度与INF-γ（Rs=0．654）、IL-10（Rs=0．517）、IL-10（Rs=0．575）、IL-1β（Rs=0．413）、IL4（Rs=0．508）、IL-6（Rs=0．446）及TNF-α（Rs=0．409）中度相关（Rs〈0．05），与IL-2（Rs=0．351）及IL=8（风=0．392）呈低度相关（P均〈0．05），与IL-13（Rs=-0．304）呈负相关（P〈0．05），与IL-12P40、IL-12P70及白三烯均无相关性（P均〉0．05）。结论HFMD患儿在感染病毒后其病情发展与细胞因子的表达水平有关，多数促炎因子和抗炎因子过度表达可能是发生重症HFMD的免疫病理基础。IFN-γ、IL-10、IL-12P40、IL-1α、IL-1β、IL4、IL-6、IL-8、TNF—α及IL-2的高表达可能促进HFMD的进展。

Objective To study the levels of serum cytokines expression in children with hand-foot -and- mouth disease （HFMD） and their correlation with disease severity. Methods The serum of peripheral blood were collected from 37 children with HFMD infected by enterovirus （ among them 21 cases were light HFMD and 16 cases were severe HFMD ）, and the controls were from 10 cases of Cleft lip and palate children who were without enterovirus infection,who came from the cleft palate treatment center waiting for surgery. Cytokines in serum of HFMD group and the control group （ TNF-α, IL-1α, IL-β, IL-2, IL-6, IL-8, IL-12P40, IL-l 2P70, IFN-γ, IL-4, IL-10 and IL-β ） were detected using Luminxe, and the correlations of the cytokines with disease severity were analyzed. Results 1. Cytokines （ IFN-γ, IL-10, IL-12P40, IL-1 a, IL-113, IL-4, IL-6, IL-8 and TNF-a） expression levels were found higher in the severe group than those in the control group （ all P 〈 0.02）, INF-γ and IL-2 expression levels were found higher in the severe group than those in the light disease group （all P 〈 0.02 ） ; the levels of IL-10, IL-12P40, IL-1, IL-1 13, IL-4, IL-6, IL-8 and TNF-α in the light disease cases were higher than those of the control group （ all P 〈 0.02 ） , in the light disease cases the levels of IL-13 and IL-12P70 were lower than those in the control group （all P 〈 0.02）. 2. The severity of HFMD was moderately correlated with the INF-γ（ Rs = 0.654 ）, IL-10 （ Rs = 0.517 ）, IL-1α （ Rs = 0. 575 ）, IL-113 （ Rs = 0. 413 ） , IL-4 （ Rs =0. 508 ） , IL-6 （ Rs = 0. 446 ） and TNF-α （ Rs = 0. 409 ） expression levels, and 1L-2 （ Rs = 0.351 ） and IL-2 （ Rs = 0. 392 ） had a low correlation （ all P 〈 13.05 ） , and negatively correlated with IL-13 expression （ Rs = -0. 304, P 〈 0.05 ） , Levels of IL-12P40, IL-12P70 and leukotriene had no correlation with HFMD. Conclusions The HFMD is associated with cytokines expression levels. The over expressions of most proinflammatory and antiinflammatory factors may be the immunopathological basis for the pathogenesis of HFMD. The research suggests that the higher expressions of the cytokines （ IFN-γ, IL-10, IL-12P40, IL-1, IL-1β, IL-4, IL-6, IL-8, TNF-a and IL-2） in people＇s blood are able to advance HFMD progress.