慢性扁桃腺炎患儿T淋巴细胞表型及功能分析

T lymphocyte phenotype and function in children with chronic tonsillitis

目的 探讨慢性扁桃腺炎患儿T淋巴细胞表型和功能障碍情况,为分析其病因和发病机制提供临 床和理论依据。方法 采用免疫荧光标记和流式细胞仪技术检测了27例慢性扁桃腺炎患儿和21例健康儿童外 周血T细胞亚群、B细胞及NK细胞的表面标记和T细胞活化后表面分子(CD3+/HLA DR+T和CD3+/CD25+)的 表达;同时采用ELISA方法检测了患儿和对照组血清中Th1型细胞因子IL 2和IFN γ的水平。结果 与对照组比 较,慢性扁桃腺炎患儿CD4+T细胞和CD3+/HLA DR+T活化细胞的阳性率显著降低(28.6%±4.4%vs25.4% ±4.5%,P<0.05;5.7%±1.9%vs3.9%±1.6%,P<0.01),CD4+/CD8+比值降低(1.17±0.30vs0.92± 0.18,P<0.01);但患儿CD3+T细胞、CD8+T细胞和CD3+/CD25+阳性的T细胞与对照组比较差异均无显著意 义。患儿CD19+B细胞阳性率、与Th1细胞功能有关的IL 2和IFN γ表达水平也较对照组显著降低(P<0.05或 P<0.05);而两组CD3 /CD(16+56)+NK细胞的阳性率无显著差异。结论 慢性扁桃腺炎患儿存在CD4+T细 胞减少,T细胞活化障碍,Th1细胞功能异常及B细胞减少,这可能是患儿反复感染和病程迁延的主要原因之一。

Objective This study examined T lymphocyte phenotype and function in the peripheral blood of children with chronic tonsillitis in order to provide a basis for uncovering the pathogenesis of chronic tonsillitis. Methods The expressions of surface markers of T cell subsets, B cells and NK cells and expressions of membrane molecule of activated T cells(CD3 +/HLA-DR + T and CD3 +/CD25 +) were assayed by immunofluorescence and flow cytometry in 27 children with chronic tonsillitis (Study group) and 21 healthy children (Control group). Meanwhile, the levels of IL-2 and IFN-γ were detected using ELISA. Results CD4 + cells and CD3 +/HLA-DR + activated T cells were expressed in 25.4%± 4.5% and 3.9%±1.6% in the Study group but 28.6% ± 4.4% and 5.7%±1.9% in the Control group (P<0.05 and <0.01, respectively). The ratio of CD +4/CD8 + of T cells in the Study group was significantly decreased compared with the Control group (0.92 ± 0.18 vs 1.17 ± 0.30,P<0.01). CD19 + B cells were expressed at a lower level in the Study group (9.9% ±3.0% vs 13.1%± 5.6%, P<0.05). The levels of IL-2 and IFN-γ related to Th1 cells function were also significantly lower in the Study group than those in the Control group (P<0.01). There were no significant differences in the number of CD3 + T cells, CD8 + T cells, CD3 +/CD25 + T cells and CD3 -/CD (16+56) + NK cells between the two groups.Conclusions There are lower CD4 + cell expression and B cell expression, and T cell dysfunction and Th1 cell dysfunction may be present in children with chronic tonsillitis, which may contribute to the pathogenesis of recurrent tonsillitis.