轮状病毒腹泻小儿特异性体液免疫应答的研究

Study on specific humoral immune response in children with rotavirus diarrhea

目的 通过对轮状病毒腹泻小儿特异性体液免疫应答的研究,为有效预防和治疗轮状病毒感染提供理论依据.方法 75例粪轮状病毒检测阳性患儿（腹泻组）及45例近期无腹泻和其他感染性疾病小儿（对照组）,采用ELISA法检测抗原及血浆和粪标本中的特异性抗体;采用反转录PCR法确定轮状病毒基因型;采用荧光定量PCR法进行外周血单个核细胞细胞因子mRNA表达的检测.结果 腹泻组轮状病毒G分型以G3型（77.3%,58/75）为主,P分型以P8型（82.7%,62/75）为主;腹泻组血浆中特异性抗体滴度均明显高于对照组,粪标本中IgA抗体滴度的增高尤为显著;腹泻组患儿CD19＋细胞比率为（30.8±7.9）%,显著高于对照组的（23.1±7.7）%（P=0.009）.CD4＋细胞比率明显下降（P=0.005）,IL-12p40 mRNA的表达水平在疾病全程均比对照组明显升高（P＜0.01）.结论 轮状病毒感染小儿免疫应答以特异性体液免疫,尤其是黏膜免疫的显著增强为主要特点.

Objective To apply the theory basis for effectively preventing and treating rotavirus infection by studying on specific humoral immune response in children with rotavirus diarrhea. Methods Seventy-five patients of children （diarrhea group ） and 45 controls （control group） were selected. The antigen and specific antibody in plasma and stool were detected by ELISA method;the type of viral gene was confirmed by reverse transcription PCR method;the expression of mRNA in peripheral blood mononuclear cell was measured by fluorescent light quantitation PCR method. Results In diarrhea group, rotavirus G typing to G3 dominated, accounting for 77.3% （58/75）, P sub-type to P8 mainly, accounting for 82.7% （62/75）. Rotavirus-specific antibody titers of plasma in diarrhea group were significantly higher than those in control group, IgA antibody titers of stool increased significantly, not only higher than that in control group and plasma. The percentage of CD19＋ cells in diarrhea group [（30.8 ± 7.9）%] was significantly higher than that in control group [（23.1 ± 7.7 ）%] （P = 0.009 ）. And the proportion of CD4＋ cells decreased significantly （P = 0.005 ）, the expression level of IL- 12p40 mRNA in the entire process in diarrhea group was significantly higher than that in control group（P〈 0.01 ）. Conclusion Children with acute rotavirus infection early in the immune response to specific humoral immunity, especially mucosal immune to significantly improve the main features.