B细胞及永生B细胞在传染性单核细胞增多症患儿中的动态变化

Dynamic Changes of B Cells Lymphocytes and Immortalized B Cells in Children with Infectious Mononucleosis

目的探讨儿童传染性单核细胞增多症(IM)不同时期永生B细胞(CD19+CD23+)及B细胞(CD19+)的变化及其规律。方法在病程急性期,病程1、3、6个月分别采集30例IM患儿外周静脉血2mL,并分离单个核细胞,采用流式细胞术检测IM患儿及健康对照组儿童外周血单个核细胞CD19+CD23+及CD19+分子表达。结果IM患儿急性期CD19+CD23+[(0.24±0.13)%]及CD19+[(3.89±1.32)%]细胞明显降低,与其余各期及健康对照组比较均有显著差异(Pa<0.001);随时间推移及感染控制CD19+CD23+及CD19+逐渐升高,但病程1个月[CD19+CD23+(0.68±0.32)%,CD19+(8.63±2.15)%]仍低于病程3个月[CD19+CD23+(1.60±0.51)%,CD19+(15.27±3.92)%]、病程6个月[CD19+CD23+(1.30±0.50)%,CD19+(14.60±4.80)%]及健康对照组[CD19+CD23+(1.35±0.42)%,CD19+(18.91±3.53)%](Pa<0.001);病程3个月、6个月CD19+CD23+及CD19+细胞比较无显著性差异(Pa>0.05);病程3个月和6个月CD19+CD23+与健康对照组比较无显著性差异(Pa>0.05),但CD19+仍低于健康对照组,有显著性差异(Pa<0.001)。结论IM患儿急性期存在继发性体液免疫功能低下,并持续至临床症状消失后较长时间,该结果为临床应用静脉丙种球蛋白治疗IM提供了理论依据;为探索正常免疫个体永生B细胞被有效控制的机制提供了一个人体模型。

Objective To explore the changes and their rules of immortalized B cells （CD19^＋ CD23 ^＋ ） and B cells （CD19 ^＋ ） in children with infections mononucleosis （IM）. Methods The expressions of CD19 ^＋ CD23^ ＋ , CD19 ^＋ on peripheral blood mononuelear cells in 30 patients with IM were determined by flow cytometry in acute phase, convalescent phase （the first month, the 3^rd month, the 6^th month） and healthy control group. Results The expressions of CD19^ ＋ CD23 ^＋ , CD19 ^＋ were markedly decreased in the acute stage [ CD19 ^＋ CD23^ ＋ （0.24 ± 0. 13 ） % , CD19^ ＋ （3.89 ± 1.32） % ]. One way analysis of variance among 5 groups were significantly different （ Pa 〈 0. 001 ）. Compared with the 3rd month of convalescent phase [ CD19 ^＋ CD23 ^＋ （ 1.60 ± 0.51 ） %, CD19 ^＋ （ 15.27 ± 3.92 ） % ], the 6^th month [ CD19 ^＋ CD23 ^＋ （ 1.30 ± 0.50） %, CD19 ^＋ （14.60 ±4.80）% ] and healthy control group[ CD19 ^＋CD23^ ＋ （1.35 ±0.42）% ,CD19^ ＋ （ 18.91 ±3.53）% ] ,the expression of CD19 ^＋ CD23 ^＋ , CD19^ ＋ in the first month of convalescent phase[ CD19 ^＋ CD23 ^＋ （0.68 ± 0.32） %, CD19 ^＋ （8.63 ± 2.15 ） % ] were obviously decreased （P 〈0.001 ）. There were significant differences on the expressions of CD19 ^＋ CD23^ ＋ , CD19^ ＋ between the 3^rd month and the 6^th month （Pa 〉 0.05 ）. Compared with healthy control group ,there was no significant difference on the expression of CD19^＋ CD23^ ＋ of the 3^rd month and the 6^th month （P 〉 0.05 ）, but the expression of CD19^＋ in the 3^rd month and the 6^th month were lower than that of healthy control group（P 〈 0. 001 ）. Conclusions The patients with IM have secondary humoral immunosuppression,which continued for long time after the recovery of the disease. This study shows an experimental evidence to the therapy with immunoglobulin. It offers a model that the immortalized B cells are effectively inhibited in bodies with normal immunity.