IL-2等6种细胞因子与儿童支气管哮喘关系的研究

Studies on the Effects of Cytokines upon the Development of Children' Asthma

观察急性发作期、激素治疗后缓解期支气管哮喘患儿血浆细胞因子的变化,探讨儿童支气管哮喘与细胞因子的关系。采用免疫分析技术对64例急性发作期支气管哮喘患儿、45例缓解期患儿及20例正常儿童血浆IL-2、sIL-2R、IL-4、IL-5、IL-8、TNF-α、IgE等细胞因子水平进行测定;用逆转录聚合酶键反应技术（RT-PCR）对外周淋巴细胞IL-4、IL-5mRNA表达进行定量分析。结果:（1）发作期哮喘患儿血浆IL-2、sIL-2R、IL-4、IL-5、IL-8、TNF-α和IgE水平均明显高于正常对照组（P值均<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）。（2）发作期患儿外周淋巴细胞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。结论:（1）本研究结果提示细胞因子的释放与哮喘的发作密切相关。（2）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TNF-α的升高表明中性粒细胞和单核巨噬细胞可能参与哮喘的发作。（3）糖皮质激素抑制多种细胞因子的释放,可能是其治疗哮喘的主要机制。

To investigate the effects of cytokines upon the development cytokines of children's asthma the plasma levels of IL-2, sIL-2R, IL-4, IL-5, IL-8, TNF-a and IgE were measured with radio immunoassays in 64 cases during attacks, 45 cases at remission as well as normal subjects. Meanwhile, IL-4 and IL-5 mRNA expressions in lymphocytes were detected with RT-PCR. The results showed: 1. The plasma levels of IL-2, sIL-2R, IL-4, IL-5, IL-8, TNF-a, IgE of children suffering from attacks of asthma were significantly higher than those of the normal controls, (P< 0. 001 ), most prominently for the changes of IL-4, IL-5 and IgE. Those of the asthmatic childrenat remission were apparently reduced, but the levels of IL-4, IL-5 and IgE remained still rather higher than those of the normal subjects. 2. The expressions of IL-4 and IL-5 mRNA in the peripheral blood lympocytes of asthmatic children during attackincreased, and after treatment they reduced with remissions. Furthermore , the plasma levels of IL-4 and IL-5 correlated positively with the expressions of IL-4 and IL-5 mRNA. (rl = 0. 67, r2 = 0.74, P<0.001) This study suggests that the release of nonspecific inflammatory mediators may play an important role in the pathogenesis of children's asthma.