卡介菌多糖核酸注射液和特异性免疫治疗对哮喘的疗效

Effect of Polysaccharide Nucleic Acid Fraction of Bacillus Calmette-Guerin and Specific Immunotherapy on Children with Asthma

目的研究卡介菌多糖核酸(BCG-PNA)和特异性免疫治疗(SIT)对哮喘患儿肺功能、血清IgE和分泌细胞因子的影响。方法用BCG-PNA和SIT治疗哮喘患儿45例,治疗前后检测肺功能,酶联免疫吸附试验检测血清IgE和外周血单个核细胞分泌细胞因子IL-4、IFN-γ、IL-13、IL-12水平。结果BCG-PNA和SIT明显改善哮喘患儿的用力肺活量、第1秒用力呼气容量、25%最大呼气流量等指标,降低血清IgE,抑制IL-4、IL-13分泌,促进IFN-γ、IL-12产生,两者联合治疗对于降低IL-13、增加IFN-γ产生有协同作用。结论BCG-PNA和SIT能改善哮喘患儿肺功能,增强Th1反应,降低Th2应答,调节Th1/Th2平衡。两者联合治疗对改善哮喘患儿失衡的细胞因子网络有一定协同作用。

Objective To explore the effects of polysaccharide nucleic acid fraction of bacillus calrnette - guerin（ BCG- PNA） and specific immunotherapy（SIT） on pulmonary function, serum immunoglobulin E（IgE） and secretions of cytokines in children with asthma. Methods Before and after treatment with BCG- PNA and SIT on 45 children with asthma, pulmonary function was analyzed and serum IgE and cytokines secreted by peripheral blood mononuclear cells were detected by enzyme - linked irnmunosorbent assay. Results BCG- PNA and SIT improved forced vital capacity, forced expiratory volume in one second, V25 of pulmonary function, decreased serum IgE, enhanced the secretions of IFN-γ, IL- 12, but decreased IL- 4, IL- 13. Combination of these two treatments appeared stronger effect in depressing IL - 13 and increasing IFN -γ. Conclusions BCG - PNA and SIT improve pulmonary function and Thl response, reduce Th2 response, regulate the balance between Thl and Th2 in children with asthma. Combination of them has stronger effect on changing unbalance of cytokines network.