儿童哮喘患者外周血ILC2细胞和Th2型细胞相关因子水平变化及与临床相关性研究

Changes of ILC2 Cells and Th2 Cell Related Factors in Peripheral Blood of Children with Asthma and Their Clinical Relevance

目的探讨支气管哮喘患儿外周血中2型固有免疫细胞(type2 innate lymphoid cells ILC2)和Th2型细胞相关因子水平变化及其临床意义。方法选取2019年1月~2020年5月在宝鸡高新人民医院确诊的67例急性发作期支气管哮喘患儿作为研究对象,根据发病严重程度分为重度-危重组23例和轻-中度组44例;并选取同期健康体检的45例儿童作为对照组。检测两组血清ILC2细胞比例和IL-4,IL-5,IL-10和IL-13水平,记录两组肺功能指标:第一秒用力呼气量(FEV1)、用力肺活量(FVC)及最大呼气峰流速(PEF);并分析ILC2细胞比例和IL-4,IL-5,IL-10和IL-13水平与肺功能指标的相关性。结果支气管哮喘组患儿外周血ILC2细胞比例及IL-4,IL-5和IL-13水平明显高于对照组,差异均有统计学意义(F=24.419~209.627,均P<0.001);IL-10水平及肺功能指标FVC,FEV1和PEF明显低于对照组,差异均有统计学意义(F=80.826~298.942,均P<0.001)。重度-危重组支气管哮喘患儿外周血ILC2细胞比例和IL-4,IL-5,IL-10和IL-13水平及肺功能指标变化较轻-中度组更为显著,差异均有统计学意义(t=1.990~7.848,P均<0.05)。支气管哮喘患儿外周血ILC2细胞比例及IL-4,IL-5和IL-13水平与FVC,FEV1和PEF值呈显著负相关,差异均有统计学意义(r=0.564~0.712,均P<0.01);IL-10水平与FVC,FEV1和PEF值呈显著正相关,差异均有统计学意义(r=0.537~0.603,均P<0.01)。结论急性发作期支气管哮喘患儿外周血ILC2细胞比例及Th2型细胞相关因子水平明显升高或降低,与哮喘患儿肺功能及病情严重程度显著相关,对其进行检测有助于评估支气管哮喘患儿病情程度,为临床提供理论指导。

Objective To investigate the changes and clinical significance of ILC2 cells and Th2 cell related factors in peripheral blood of children with bronchial asthma.Methods A total of 67 children with acute onset bronchial asthma diagnosed in Baoji Gaoxin People’s Hospital from January 2019 to May 2020 were selected as the research objects.According to the severity of the disease,they were divided into the severe-critical group(23 cases)and the mild-moderate group(44 cases).A total of 45 children who underwent physical examination during the same period were selected as controls.Serum ILC2 cell ratio and IL-4,IL-5,IL-10 and IL-13 levels were detected in the two groups.Lung function indexes of the two groups were recorded:forced expiratory volume in the first second(FEV1),forced vital capacity(FVC)and maximum expiratory peak velocity(PEF).The correlation between ILC2 cell proportion and IL-4,IL-5,IL-10 and IL-13 levels and lung function was analyzed.Results The proportion of ILC2 cells and levels of IL-4,IL-5 and IL-13 in peripheral blood of children with bronchial asthma were significantly higher than those in the control group,and the differences were statistically significant(F=24.419~209.627,all P<0.001).The levels of IL-10 and lung function indexes of FVC,FEV1,PEF were significantly lower than those of the control group,and the differences were statistically significant(F=80.826~298.942,all P<0.001).The ILC2 cell proportion,IL-4,IL-5,IL-10 and IL-13 levels and pulmonary function indicators in the peripheral blood of children with bronchial asthma in the seere-critical group were more significant than those in the mild-moderate group,with statistically significant differences(t=1.990~7.848,all P<0.05).The percentages of ILC2 cells and IL-4,IL-5 and IL-13 levels in peripheral blood of children with bronchial asthma were negatively correlated with the values of FVC,FEV1and PEF,with statistically significant differences(r=0.564~0.712,all P<0.01).IL-10 level was positively correlated with FVC,FEV1 and PEF values,and the difference was statistically significant(r=0.537~0.603,all P<0.01).Conclusion The proportion of ILC2 cells and the level of Th2 cell related factors in peripheral blood of children with bronchial asthma during acute attack were significantly increased or decreased,which were significantly correlated with the pulmonary function and severity of the disease in children with asthma.The detection of ILC2 cells was helpful to assess the severity of the disease in children with bronchial asthma,and could provide theoretical guidance for clinical practice.