抗原特异性免疫治疗花粉症与细胞因子的相关性

Pertinence between Antigen Specific Immunotherapy Treating Pollenosis and Cytokine

目的探讨抗原特异性免疫治疗花粉症与细胞因子的相关性。方法将蒿草花粉过敏的60例患者随机分为快速免疫治疗和常规免疫治疗2组,用蒿草花粉变应原进行季节前减敏治疗。分别测定细胞因子白介素-4(IL-4)、γ-干扰素(γ-IFN)和总IgE(tIgE)、特异性IgE(sIgE)血清中含量。比较治疗前、治疗后、维持治疗1个月后水平变化和临床效果。结果与治疗前比较,花粉症快速组治疗后血清中tIgE、sIgE、IL-4、γ-IFN含量变化,差异无统计学意义(P1>0.05)。维持治疗1个月后,sIgE升高差异仍然无统计学意义(P2>0.05),而IL-4水平明显降低(P2<0.01),tIgE、γ-IFN水平明显升高(P2<0.01)。常规免疫治疗组:治疗后血清中tIgE、γ-IFN明显升高(P1<0.01),sIgE、IL-4没有明显变化(P1>0.05)。维持治疗1个月后与治疗前比较,tIgE、sIgE、γ-IFN明显升高(P2<0.01),IL-4明显降低(P2<0.01)。2组抗原特异性免疫治疗均取得了显著临床效果,有效率比较,差异无统计学意义(P>0.05)。结论特异性免疫治疗能明显改善花粉症的临床症状和相关细胞因子、特异性抗体水平,IL-4、γ-IFN水平变化可以作为免疫治疗疗效观察的有效生物学指标。

[ Objective ] To evaluate the pertinence between antigen specific immunotherapy in treating pollenosis and cutokine. [ Methods ] 60 patients with Artemisia allergy were stochastically divided into two groups, namely, tachyphylaxis group and conventional hyposensitization group; the patients were treated with Artemisia pollen allergen before July; detection was made on the contents of serum 4 （IL-4） ,γ-INF, total IgE （tIgE） and specific IgE （ sIgE ） ; comparison was made on the changes before and after treatment and after one month of maintain treatment. [ Results] The comparison in the taehyphylaxis group showed no significant difference in the content of serum tlgE, sIgE, IL-4 and γ-IFN before and after the treatment （ P 〉 0.05 ）, after one month of main- tenance treatment, the elevated level of slgE was still not significant （ P 〉 0.05 ） , while the level of IL-4 decreased significantly {P 〈 0.01 ） ; the result in the conventional hyposensitization group： the serum tlgE and γ-INF increased significantly after treatment （P 〈 0. 01 ） , the level of sIgE and IL-4 had no obvious change （P 〉 0. 05）, after one month of maintenance treatment, the level of tlgE, sIgE and γ-IFN increased significantly （ P 〈 0.01 ） , that of IL-4 decreased significantly （ P 〈 0. 01 ） ; the antigen specific im- munotherapy in the two groups both have proved to have significantly clinical effect, the difference in the effective rates was not significant （ P 〉 0.05）. [ Conclusion] Antigen specific immunotherapy can improve the symptoms, cytokine and specific antibody of pollinosis; the level of IL-4 and γ-INF can be used as an effective biological index for the observation of immunotherapy effect.