草分枝杆菌对尖锐湿疣患者Th1/Th2免疫平衡的调节作用

Regulating Role of Mycobacterium Phlei F.U.36 on Th1/Th2 Immune Balance in Patients with Condyloma Acuminatum

目的:观察草分枝杆菌对尖锐湿疣患者血清IL-12和IL-4水平的影响,探讨草分枝杆茵对尖锐湿疣患者,Th1/Th2免疫调节作用的机制。方法:将68例尖锐湿疣患者随机分为治疗组和对照组。治疗组采用局部电灼术和肌注草分枝杆菌治疗,对照组只采用局部电灼术治疗。采用双抗体夹心ELISA法分别检测治疗前和治疗3个月后患者血清IL-12和IL-4水平的变化,并进行临床疗效的观察和生存质量的评估。结果:两组患者治疗前血清IL-12和IL-4水平比较差异均无统计学意义。治疗组治疗后血清IL-12水平较治疗前明显升高,血清IL-4水平明显降低(P<0.05);而对照组治疗前后却无明显变化。随访3个月治疗组有4例复发,对照组有13例复发,治疗组的复发率明显低于对照组(P<0.05)。两组患者治疗前生存质量评分比较差异均无统计学意义。治疗组治疗后生存质量评分明显提高,生理、心理、社会和环境4个领域的评分与治疗前比较均有明显增加(P<0.05),而对照组治疗前后却无明显变化。结论:草分枝杆菌能明显降低尖锐湿疣复发率,提高患者的生存质量。作用机制可能是通过影响IL-12,IFN-r和IL-4,IL-10等组成的细胞因子网络从整体上调节Th1/Th2免疫平衡和增强细胞免疫功能。

Objective： To observe the influence of Mycobacterium Phlei F. U. 36 on serum IL-12 and IL-4 levels and to explore its role in Th1/Th2 immune regulation mechanism in patients with eondyloma aeuminatum. Method： Sixty-eight eases of eondyloma aeu- minatum were divided into treatment group and control group randomly. Treatment group was used local fulguration treatment and intra- musenlar injection of Mycobacterium Phlei F. U. 36. Control group：only used local fnlguration treatment. Serum IL-12 and IL-4 levels were determined by Double-antibody sandwich ELISA before treatment and 3 months after treatment in patients ,and clinical efficacy and quality of life were assessed. Result： There were no significant differences in serum IL-12 and IL-4 levels in the two groups of patients before treatment. Serum IL-12 levels were significantly increased after treatment, and serum IL-4 levels were significantly decreased in the treatment group; While there were no significant changes before and after treatment in the control group. Mter 3 months follow-up, four cases of recurrence were found in the treatment group while 13 patients relapsed in the control group. The relapse rate in the treat- ment group was significantly lower than that in the control group. There was no significant difference in quality of life score in the two groups of patients before treatment. After treatment, the quality of life score was significantly improved in physical, psychological, social and environmental areas and the score was significantly increased, while in the control group, no significant changes were found before and after treatment. Conclusion： Mycobacterium Phlei F. U. 36 can significantly reduce the relapse rate and improve the quality of life of patients with condyloma acuminatum. Its mechanism may be through its influence on IL-12 ,IFN-r and IL-4,IL-10 and other compo- nents of the cytokine network which regulate the overall balance of Th1/Th2 immune cells and enhance immune function.