特应质婴儿呼吸道病毒感染的易感性及相关细胞因子的表达

Susceptibility of Respiratory Virus Infection and Expressions of Related Cytokines in Atopic Infants

目的探讨特应质婴儿对常见呼吸道病毒感染的易感性及病毒感染后细胞因子IL-12、IL-27等的表达变化。方法对116例反复喘息的婴幼儿用AllergyScreen变应原检测系统进行屋尘螨粉尘螨、豚草、猫毛皮屑、狗毛皮屑、蟑螂、真菌、葎草、梧桐、鸡蛋、牛奶、鱼、虾、蟹、牛肉、羊肉、腰果、花生、黄豆、芒果、小麦等20种常见吸入性变应原和食入性变应原检测,以sIgE>0.35 U.L-1作为阳性诊断标准,只要有一个阳性即为特应质,否则为非特应质。同时取其鼻咽分泌物用反转录(RT)-PCR方法进行呼吸道合胞病毒、鼻病毒、流感病毒、副流感病毒、人偏肺病毒、冠状病毒(博卡病毒)、肠病毒检测,根据病毒和变应原检测结果将研究对象分为特应质病毒阳性组和非特应质病毒阳性组,用ELISA法测定2组患儿血清IL-12、IL-27水平。结果 116例反复喘息患儿中病毒感染阳性77例,阳性率为66.4%;变应原筛查阳性65例,阳性率为56.0%。特应质病毒阳性组病毒感染阳性率为75.4%,非特应质病毒阳性组病毒感染阳性率为54.9%,二组病毒感染阳性率比较差异有统计学意义(χ2=5.37,P<0.05),二组病毒感染种类比较差异无统计学意义(χ2=0.012 7,P>0.05)。病毒感染时,特应质病毒阳性组患儿血清IL-12、IL-27水平均明显高于非特应质病毒阳性组(t=2.579、2.573,Pa<0.01)。结论呼吸道病毒感染是诱发婴幼儿喘息的主要原因,特应质患儿对呼吸道病毒感染存在易感性。

Objective To explore the susceptibility of the respiratory virus infection in atopic and non-atopic infants and observe the expressions of related cytokines IL-12 and IL-27.Methods In serum samples from 116 cases of recurrent wheezing children,Allergy-Screen allergen detection system was used to quantitatively screen the 20 commonly inhaled and ingested allergen such as dust,ambrosia,mite,cockroach,mold,humulus,phoenix tree,egg,milk,fish,shrimp,crab,beef,lamb,cashew,peanut,soybean,mango and wheat etc.sIgE0.35 U·L^-1 was taken as standard of positive detection.Among all the 20 allergen,atopy could be diagnosed by one positive allergen detected.The controlling non-atopy group were the controlls.Reverse transcription polymerase chain reaction assay was used to detect viruses in the nasopharyngeal secretions of these patients,including respiratory syncytial viruses,rhincvirus,influenza virus,parainfluenza,human metocpneumo virus,human bocavirus,enterovirus.The virus-positive patients were then divided into 2 groups,atopic virus-positive group and non-atopic virus-positive group.Cytokines IL-12 and IL-27 were further determined using enzyme-linked immunosorbent assay me-thod.Results A total of 65 cases（56.0%） and 77 cases（66.4%） out of 116 cases of recurrent wheezing children,were found to be allergen-positive and virus-positive,respectively.The virus-positive rate was 75.4% in atopic group and 54.9% in non-atopic group.There was a significant difference in the virus-positive rates between the atopic and non-atopic group（χ^2=5.37,P0.05）,whereas no difference was for the types of viruses（χ^2=0.012 7,P〈0.05）.Furthermore,serum IL-12 and IL-27 in the atopic group were significantly higher than those in the non-atopic group（t=2.579,2.573,Pa〈0.01）.Conclusions Respiratory virus infection might be the major cause of the induction of wheezing in children,and the atopic infants would be more susceptible to the respiratory virus infection.