人偏肺病毒与呼吸道合胞病毒感染患儿外周血细胞因子变化及意义

Changes and significance of cytokine profiles in children with respiratory tract infection of human metapneumovirus or respiratory syncytial virus

目的探讨细胞因子在人类偏肺病毒(hMPV)与呼吸道合胞病毒(RSV)感染发病机制中的作用。方法应用流式细胞微球阵列技术(CBA)检测25例hMPV感染(hMPV组)、35例RSV感染患儿(RSV组)和10例正常对照组儿童(C组)外周血细胞因子IL-8、IL-6、IL-1β、TNF-α、IL-10、IL-12p70水平;hMPV组和RSV组根据临床表现分为支气管肺炎亚组、毛细支气管炎亚组和哮喘急性发作亚组,分析不同喘息状态患儿外周血细胞因子的变化。结果 hMPV组和RSV组患儿外周血IL-8、IL-1β、IL-6、TNF-α、IL-10水平显著高于C组;hMPV组TNF-α水平低于RSV组。hMPV组和RSV组哮喘急性发作亚组患儿IL-6水平均高于其他两亚组。hMPV组毛细支气管炎亚组和哮喘急性发作亚组TNF-α水平显著高于支气管肺炎亚组。结论 IL-8、IL-6、IL-1β、TNF-α和IL-10等细胞因子参与了hMPV感染、RSV感染后炎症反应;IL-6、TNF-α在hMPV感染和RSV感染喘息发生过程中起重要作用;hMPV感染诱生的细胞因子与RSV并不完全相同,可能通过不同的免疫途径介导炎症反应。

Objective To investigate the changes and significance of serum cytokines in children with respiratory tract infection of human metapneumovirus（hMPV） or respiratory syncytial virus（RSV）.Methods The serum levels of tumor necrosis factor（TNF）-α,interleukin（IL）-8,IL-1β,IL-6,IL-10 and IL-12p70 were detected with cytometric bead array（CBA） in 25 hMPV patients（group A）,35 RSV patients（group B） and 10 normal controls（group C）.The relation of the changes with clinical features was analyzed.Results The serum levels of IL-8,IL-1β,IL-6,TNF-α and IL-10 were higher in groups of hMPV and RSV than those in group C.The serum TNF-αwas lower in group hMPV than that in group B.In hMPV and RSV patients,the level of IL-6 was obviously higher in patients with asthma exacerbation than that in those with bronchiolitis and bronchopneumonia.The serum concentrations of TNF-α in the hMPV patients with asthma exacerbations and bronchiolitis were significantly higher than those with bronchopneumonia.Conclusion Cytokines of IL-8,IL-1β,IL-6,TNF-α and IL-10 participate in inflammatory responses after hMPV or RSV infection.IL-6 and TNF-α play important roles in the wheezing induced by hMPV or RSV infection.Cytokines elicited by hMPV and RSV are not completely similar.HMPV and RSV may mediate inflammatory responses via different ways.