毛细支气管炎细胞因子与发病机理的研究

ANALYSIS OF CYTOKINE PRODUCTION IN INFANTS WITH BRONCHIOLITIS

为了解毛支发病机理与机体免疫功能的关系，探讨环境与遗传因素对发病的影响，对３０例不同病毒感染的毛支患儿取血清及外周血单个核细胞（ＰＢＭＣ）培养，用ＥＬＩＳＡ方法测定培养上清中细胞因子及血清ＩｇＥ浓度。结果表明：①毛支急性期ＩＦＮ－γ水平降低，ＩＬ－４、ＩＬ－１０及血清ＩｇＥ水平增高。②毛支ＩＬ－４、ＩＬ－１０、ＩｇＥ水平增高与感染病毒的种类关系不明显，与机体遗传特应质有关。提示：毛支患儿存在细胞免疫功能异常，表现在细胞因子分泌紊乱。遗传因素在细胞因子分泌异常中可能有重要作用。

To explore the relation between poroduction of cytokines and the pathogenesis in bronchiolitis,30 infants with bronchiolitis,15 with pneumonia and 15 age matched healthy controls were involved in this study.The virologic data showed that bronchiolitis group was 10 RSV positive,10 ADV positive and 10 Flu or PIV poisitive.Pneumonia group was 7 RSV positive,4 ADV positive and 4 Flu or PIV positive.T helper cell derived cytokines in cultured supernatants of PBMC and serum IgE were assayed by using sandwich ELISA.Compared with those in controls,the IFN γ level was obviously decreased( P <0.01)while the levels of IL 4,IL 10 and IgE were significantly increased( P <0.01,0.01,0.01)in patients with bronchiolitis.Neither statistical differences of cytokine and IgE levels among different kind of virus positive groups,nor obvious differences of IL 2 level among normal,bronchiolitis,and pneumonia groups were observed( P >0.05).Furthermore,30 infants with bronchiolitis were divided into atopy + and atopy - groups,in which the former had lower levels of IFN γ( P <0.05)but higher IL 4,IL 10 and IgE compared with the latters( P <0.01,0.05,0.01).No apparent differences of IL 2 level between the two groups( P >0.05).These results suggest that abnormal cytokine production exists in the infants with bronchiolitis,which may be associated with the pathogenesis of bronchiolitis