吸入糖皮质激素对哮喘儿童细胞免疫功能的影响

EFFECT OF INHALED GLUCOCORTICOID ON IMMUNE FUNCTION OF CHILDREN WITH ASTHMA

为了解糖皮质激素对免疫功能的作用，检测了哮喘发作期患儿。对经丙酸倍氯松（ＢＤＰ）吸入治疗的患儿及正常儿童外周血淋巴细胞膜ＩＬ－２受体（ｍＩＬ－２Ｒ）、超微结构、血浆游离ＩＬ－２受体（ｓＩＬ－２Ｒ）、淋巴细胞亚群及ＢＤＰ对体外培养淋巴细胞ｍＩＬ－２Ｒ的表达进行比较。结果显示，ＢＤＰ可以明显抑制ＰＨＡ刺激引起的体外培养淋巴细胞ｍＩＬ－２Ｒ的表达，引起淋巴细胞的凋亡，而吸入ＢＤＰ（２００μｇ／ｄ）的哮喘患儿（缓解期）除ｓＩＬ－２Ｒ比哮喘发作期显著降低（Ｐ＜０．０５）外，外周血淋巴细胞ｍＩＬ－２Ｒ及淋巴细胞亚群并未出现显著变化．结果提示，抑制淋巴细胞ｍＩＬ－２Ｒ表达和淋巴细胞活化可能是ＢＤＰ治疗哮喘等变态反应的重要机制之一。吸入ＢＤＰ主要是呼吸道局部作用。

For understanding the effect of inhaled glucocorticoid on immune function in children with asthma,some immune parameters were investigated in acute asthmatic children,normal children and asthmatic children treated by beclometason dipropionate(BDP).The parameters were IL 2 receptors on membrane (mIL 2R) and ultrastructure of lymphocytes,soluble IL 2 receptors(sIL 2R),T lymphocyte subsets and the effect of BDP on the expression of mIL 2R in cultured lymphocytes.The results showed that BDP obviously inhibited expression of mIL 2R in PHA activated lymphocytes and induced apoptosis of cultural lymphocytes.However,except quantity of sIL 2R,T lymphocyte subsets and the expression of mIL 2R of peripheral blood lymphocytes were no significant difference between the children with asthma and the asthmatic children treaded by inhaled BDP.The results suggested that it might be one of the importent mechanism of BDP treating asthma that BDP inhibited the expression of mIL 2R and the action of lymphocytes. Inhaled BDP might act on the airway, but no remarkable effect on the parameters of systemic cellular immunity.