毛细支气管炎后反复喘息的免疫机理研究

Research of immunological mechanism on recurrent wheezing following bronchiolitis

为了解毛细支气管炎(毛支)后反复喘息患儿的细胞因子分泌水平,采用ELISA法测定35例毛支随访者外周血单个核细胞(PBMC)培养上清液中细胞因子及血清IgE含量。结果表明:(1)反复喘息组中特应症阳性率(73.3％)明显高于非喘息组(25.0％,P<0.05);(2)与非喘息组比较,喘息组IFN-γ水平降低,而IL-4、IL-10、IgE水平增高(P均<0.05);(3)喘息组IL-4/IFN-γ比值及IL-10分别与血清IgE含量呈高度相关。提示毛支后反复喘息者与遗传特应体质有关;细胞因子分泌异常如T_H2类因子及IgE生成增多,可能是反复喘息的免疫学基础。

To investigate the serum cytokines level of infants with recurrent wheezing following bronchiolitis , serum IgE, IFN-γ,IL-2.IL-4 and IL-10 in the cultured supernatants of PBMC stimulated with PHA in 35 children who suffered from bronchiolitis one year ago by using sandwich ELISA. The results showed that the positive rate of atopy in recurrent wheezing group was obviously increased than that in non-wheezing group (x2 = 6. 24,P<0. 05). Compared with those in the non-wheezing group, there was a lower level of IFN-γ(g = 3. 23>.P<0. 05) and higher levels of IL-4, IL-10 and IgE (q -3. 07,2. 96,3. 85,all P<0. 05) in the wheezing group. IL-4/IFN-γ ratio and IL-10 level in the wheezing group were positively correlated with serum IgE level (r=0. 794 and 0. 796, respectively). It is suggested that children who had recurrent wheezing following bronchiolitis were probably associated with genetic atopy. Abnormal production of cytokines such as increased IL-4, IL-10 and IgE levels may be immunological basis of recurrent wheezing.