非特异性炎性介质在儿童支气管哮喘发病中的作用

EFFECTS OF NONSPECIFIC INFLAMMATORY MEDIATORS AND CHILDS BRONCHIAL ASTHMA

采用免疫分析对急性发作期支气管哮喘患儿、缓解期患儿及正常对照组血浆ＩＬ－２、ｓＩＬ－２Ｒ、ＩＬ－４、ＩＬ－５、ＩＬ－８、ＴＮＦα、ＩｇＥ等炎性介质水平进行测定；用逆转录聚合酶链反应技术（ＲＴ－ＰＣＲ）对外周淋巴细胞ＩＬ－４、ＩＬ－５ｍＲＮＡ表达进行定量分析。结果发作期哮喘患儿血浆ＩＬ－２、ｓＩＬ－２Ｒ、ＩＬ－４、ＩＬ－５、ＩＬ－８、ＴＮＦα和ＩｇＥ水平均明显高于正常对照组（Ｐ＜０．００１），以ＩＬ－４、ＩＬ－５和ＩｇＥ变化最为明显，缓解期均明显下降，但ＩＬ－４、ＩＬ－５及ＩｇＥ水平仍高于正常水平（Ｐ＜０．０１）。发作期哮喘患儿外周淋巴细胞ＩＬ－４、ＩＬ－５ｍＲＮＡ表达增强，治疗缓解后减弱，同时血浆ＩＬ－４、ＩＬ－５分别与ＩＬ－４、ＩＬ－５ｍＲＮＡ呈明显正相关关系（ｒ１＝０．６７，Ｐ＜０．００１；ｒ２＝０．７４，Ｐ＜０．００１）。结果：哮喘发作期血浆多种炎性介质水平显著升高、缓解后明显下降，提示非特异性炎性介质的释放与哮喘的发作密切相关。外周淋巴细胞ＩＬ－４、ＩＬ－５强表达以及血浆ＩＬ－４、ＩＬ－５高水平，提示哮喘发作期ＴＨ２亚群的激活；同时ＩＬ－８和ＴＮＦα的升高表明中性粒细胞和单核巨噬细胞可能参与了哮喘的?

o investigate the relationship between nonspecific inflammatory mediators and child bronchial asthma and to disclose the pathogenesis of asthma. Some inflammatory mediators such as IL2, sIL2R, IL4, IL5, IL8, TNFα and IgE in 64 children at attack stage, 45 at remission satge and 20 normal subjects have been measured with ELISA and radioimmunoassy, meanwhile IL4 and IL5 mRNA expression in lymphocytes were detected with RTPCR and PCR. The results showed that:1. All inflammatory mediators of children with severe asthma were significantly higher than those of normal controls(P<0001) and decreased apparently after treatment with glucocorticoid and β2agnosit, but IL4, IL5 and IgE still showed higher levels compared with those of controls;2. The expression of IL4 and IL5 mRNA in lymphocytes of acute asthmatic children were stronger than the other two groups(P<001), furthermore a positive relationship between plasma IL4,IL5 levels and IL4, IL5 mRNA expression were found respectively(r1=0.67, r2=0.74, P<0001). This study suggested that the raise of nonspecfic inflammatory mediators may be play an important role in pathogenosis and development of child asthma.