复合抗原在哮喘免疫治疗中的作用

Complex antigen in the immunotherapy of asthma

目的:观察结核菌素纯蛋白衍生物(PPD)与特异性过敏原组成的复合抗原免疫对哮喘的治疗作用。方法:将非急性发作期的哮喘患者90例,随机分为传统治疗组(30例)、复合抗原治疗A组和B组(各30例),3组在维持原控制药基础上,传统治疗组用特异性过敏原进行脱敏治疗,每周皮下注射一剂量单位至最佳维持剂量后,每2周注射一次维持量,直至哮喘完全缓解1年;复合抗原治疗A组和B组用PPD+特异过敏原组成的复合抗原进行脱敏治疗,初始浓度和递增速度与传统组相同,维持阶段:A组每2周注射一次维持量,B组每4周注射一次维持量,直至哮喘完全缓解一年。用ELISA定量检测试剂盒检测治疗前后患者血清及痰中IL-4、IL-5、IFN-γ及IgE表达水平。结果:传统治疗组和复合抗原治疗2组治疗后血清及痰中IL-4、IL-5、IgE表达水平均显著下降,IFN-γ表达水平则明显升高,与治疗前比较均相差显著(P<0.05),但复合抗原A组和B组之间差异无显著性(P>0.05)。结论:复合免疫法能明显抑制因过敏原接触导致的以TH2应答为主的免疫反应,调节TH1/TH2的平衡,其对治疗支气管哮喘有显著疗效。

Objective:To investigate the immunotherapy effect of the complex antigen on the asthma .Methods: Ninety patients with asthma in no-acute attack period were randomly divided into traditional treatment group and complex antigen group A and group B(30 cases in each) . The traditional treatment group accepted specific allergen. A dose of 1 unit was administrated subcutaneously once a week, then, once 2 weeks after reaching the maintaince dosage. The treatment was not ceased until the asthma was completely relieved for a year. Complex antigen group received complex antigen composed of PPD(purified protein derivative)and specific allergen. In the maintaince period , group A accepted the maintainance dosage once a week, while group B received once 4 weeks. The indication for ceasing treatment was the same as that in the traditional treatment group. ELISA was used to measure the concentration of IL-4, IL-5, IgE, and IFN-r, in sputum and serum , after and before the treatment respectively . Results:The IL-4, IL-5, and IgE levels in all groups were significantly decreased while IFN-r level was dramatically increased after the treatment , the difference was significant (-P-<0.05). But there was no significant difference between the complex antigen group A and group B (-P-> 0.05). Conclusion: The complex immunity, could dramatically inhibit the immune reaction, regulate the balance between TH1 and TH2, is effective for the treatment of asthma.