过敏性哮喘患者血清TIgE、IgG_4、ECP、IL-2和IL-5水平变化及意义

ZChanges and significance of serum TIgE,IgG_4,IL-2,IL-5 and ECP in allergic asthma

目的通过研究TIgE(总免疫球蛋白E)、IgG4(免疫球蛋白G4)、IL-5(白细胞介素-5)、IL-2(白细胞介素-2)和ECP(嗜酸细胞阳离子蛋白)在过敏性哮喘发病时血清水平的变化,进一步探讨过敏性哮喘气道炎症形成的机制,并评价其反映哮喘气道炎症的临床价值。方法分别选择过敏性哮喘轻、中度发作期和缓解期患者各30例,并选15例健康体检者做对照,入选者采用ELISA法测定血清TIgE、IgG4、IL-2和IL-5水平,采用Immuno CAP检测系统测定血清ECP水平。结果过敏性哮喘发作期及缓解期血清TIgE与IgG4水平均升高,且升高趋势一致,与正常对照组比较,差异显著(P<0.05)。发作期ECP与IL-5明显升高,与缓解期及正常对照组相比均有显著差异(P<0.05)。IL-2在发作期轻度升高,但各组间比较差异不显著。发作期中TIgE与ECP间存在正相关(r=0.48,P<0.01),其他各参数间无显著直线相关关系。结论TIgE,IgG4,IL-2,IL-5和ECP能较客观地反映过敏性哮喘患者气道炎症,间接反映体内嗜酸细胞和T-淋巴细胞的免疫功能状态,在一定程度上揭示过敏性哮喘发病过程细胞和体液免疫功能的变化。

Objective To explore the pathogenesis of respiratory inflammation in asthma and evaluate the clinical values of these indexes in allergic asthma by observing the serum level of interleukin-2（IL-2）, interleukin-5 （IL-5）, total immnoglobulin E （TIgE）, immnoglobulin G4 （IgG4） and eosinophil cationic protein （ECP）. Methods Each 30 cases of allergic asthma with acute attacks from mild to moderate degree （group A） and with remission （group B） were chosen respectively, and another 15 healthy subjects were chosen as controls （group C）. Serum TIgE, IgG4, IL-2, IL-5 and ECP were measured by ELISA or Immuno-CAP system. Results Serum TIgE and IgG4 levels were significantly higher in groups A and B than in group C. There was significant difference between group A and C, B and C（P 〈 0.05 ）. ECP and IL-5 level was significant higher in group A than in group B and C （ P 〈 0.05 ）. There was significant difference between A and B, A and C（ P 〈 0.05）. IL-2 level was mildly higher in group A than in other groups, but there was no significant difference between 3 groups. Conclusion These indexes may reflect the change of cellular and humoral immune function in allergic asthma from different sides, and the pathogenesis of the respiratory inflammation in allergic asthma.