糖皮质激素与BCG用于分泌性中耳炎治疗的实验研究

The experimental study of glucocorticoids and BCG vaccine’s treatment for secretory otitis media

目的:研究糖皮质激素(Glucocorticoids,GCS)及卡介苗(Bacille calmette-guerin,BCG)疫苗在治疗分泌性中耳炎(Secretory otitis media,SOM)中的疗效及其作用机制。方法:将24只BALB/C小鼠分为4组,每组6只,其中卵清白蛋白(Ovalbumin,OVA)模型组(OVA组)、卡介苗治疗组(BCG组)、糖皮质激素治疗组(GCS组)腹腔注射卵清白蛋白致敏,然后用卵清白蛋白耳内激发2次;阴性对照组(CON组)腹腔注射生理盐水,然后生理盐水激发2次。BCG组在耳内激发前3d给予双下肢外侧皮内注射卡介苗0.02mg,GCS组在耳内激发前3d给予经口吸入强的松1mg,其它2组不作干预,4组分别于2次激发后2d处死小鼠,中耳组织做病理切片观察其形态学改变,免疫组织化学染色观察IL-4、IL-5、INF-γ、IL-12细胞因子的表达差异情况。结果:BCG组、GCS组中耳粘膜组织炎症反应较OVA组明显减轻,且GCS组与BCG组比较,炎症反应亦明显减轻,Th1型细胞因子IL-12、IFN-γ较OVA组显著增多,(P<0.05);而Th2型细胞因子IL-4、IL-5较OVA组明显减少(P<0.05),BCG在一定程度上扭转了Ⅰ型变态反应的发生发展,而GCS使Th1、Th2、型细胞因子更趋于平衡。结论:卡介苗是有效的免疫调节剂,可能通过调节Th1/Th2的细胞的平衡,达到治疗的作用。而糖皮质激素仍然是变应性炎症疾病治疗中最有效的一类药物,为临床治疗分泌性中耳炎提供依据。

Objective：To study the the mechanismof effect of glucocorticoids and BCGvaccine in the treatment of secretory otitis media. Methods：24 BALB/C mice were divided into 4 groups of 6,The OVA、BCG and GCS groups were immunized with OVA/alum and challenged with OVA.BCG group was injected with BCG 0.02 mg intraperitoneal injection 3 days before being challenged,GCS group was given the oral inhalation prednisone 1 mg for 3 days before being stimulated.And the other two groups have non-intervention,2 days later the mice were killed all,We analysed the pathology observation of the middle ear mucosa,the expression of cytokines such as IL-4、IL-5、 IFN-γand IL-12 by immunohistochemistry.Results：BCG Group,GCS group of middle ear mucosa inflammatory response than the OVA group was significantly reduced,and the GCS group,compared with BCG Group,also significantly reduce the inflammatory.Th1-type cytokines IL-12,IFN-γwas significantly increased than the OVA group,（P0.05）;while Th2-type cytokines IL-4,IL-5 was significantly reduced,（P0.05）.Conclusion：BCG is an effective immunomodulator,probably by regulating the Th1/Th2 balance.And glucocorticoids are still the the most effective drugs in the treatment of allergic inflammatory disease.The study provides the basis for the clinical treatment of secretory otitis media.