呼吸道合胞病毒支气管肺炎外周血高迁移率族蛋白B-1肿瘤坏死因子-α和T细胞亚群检测及临床意义研究

The detection and clinical significance of HMGB1,TNF-α and T lymphocyte subsets in peripheral blood of respiratory syncytial virus bronchopneumonia

目的探讨呼吸道合胞病毒(RSV)支气管肺炎患儿外周血单个核细胞(PBMCS)高迁移率族蛋白B-1(HMGB1)mRNA表达,及血浆肿瘤坏死因子-α(TNF-α)水平、T细胞亚群,并探讨HMGB1、TNF-α、T细胞亚群在RSV支气管肺炎免疫发病机制中的临床意义。方法对2007年9月至2009年3月于苏州大学附属儿童医院呼吸科住院治疗的52例RSV支气管肺炎患儿,其中25例为呼吸道合胞病毒(RSV)感染,27例为RSV和细菌混合感染。同时选择23例健康儿童作对照组,应用逆转录聚合酶链反应(RT-PCR)方法对其PBMCS HMGB1mRNA表达进行检测,并应用ELLSA法检测外周血浆TNF-α,流式细胞仪检测T细胞亚群。结果 (1)3组间PBMCS HMGB1mRNA的表达、血浆TNF-α水平差异有统计学意义(P<0.05),RSV感染组和混合感染组HMGB1的表达差异有统计学意义(P<0.05);(2)CD3+、CD3+CD8+、CD3-CD19+、CD19+CD23+、CD3-CD(16+56)+的百分比在3组间差异均有统计学意义(P<0.05);(3)CD3+、CD3+CD8+、CD3-CD(16+56)+亚群:RSV感染组和混合感染组之间差异无统计学意义(P>0.05),但较对照组有明显降低(P<0.05);(4)CD3-CD19+RSV感染组和混合感染组之间差异无统计学意义,但较对照组明显增高(P<0.05);(5)CD3+CD4+、CD4+CD25+在3组间差异无统计学意义(P>0.05);(6)混合感染组CD19+CD23+、CD4+CD25+较对照组明显增高,差异有统计学意义(P<0.05)。结论 HMGB1可能参与了RSV和细菌混合感染支气管肺炎的免疫发病过程,HMGB1与TNF-α作用机制可能不同。

Objective To investigate the expression and clinical significance of high mobility group box-1 （HMGB1） protein mRNA in peripheral blood mononuclear cells （PBMCs） , the levels of plasma tumor necrosis factor-α （TNF-α） and T lymphocyte subsets in respiratory syncytial virus （RSV） bronchopneumonia. Methods The expression of HMGB1 mRNA was detected in peripheral blood mononuclear cells（PBMCs） of 52 patients with bronchopneumonia： 25 patients infected with respiratory syncytial virus, 27 patients with respiratory syncytial virus and germ and 23 normal controls by reverse transcription-polymerase chain reaction （RT-PCR）. The levels of plasma TNF-α was measured by enzyme linked immunosorbent assay （ELISA）. T lymphocyte subsets were tested with flow cytometry. Results （1）The expression levels of HMGB1 and TNF-α were significantly different among three groups （P〈0.05）. The expression level of HMGB1 in polyinfection group was higher than that in RSV group（P〈0.05）. （2）The percentages of CD3＋,CD3＋CD8＋,CD3-CD19＋,CD19＋CD23＋ and CD3-CD（16＋56）＋ were significantly different among three groups （P〈0.05）. （3） The percentages of CD3＋,CD3＋CD8＋ and CD3-CD（16＋56）＋ were not different between polyinfection group and RSV group （P〉0.05）,but lower than those in control group（P〈0.05）. （4） The percentage of CD3-CD19＋ was not different between polyinfection group and RSV group （P〉0.05）,but higher than that in control group（P〈0.05） . （5） The percentages of CD3＋CD4＋ and CD4＋CD25＋ were of no statistical significance among three groups（P〉0.05）.（6）The percentages of CD19＋CD23＋ and CD4＋CD25＋ were higher in polyinfection group than those in RSV group（P〈0.05）. Conclusion HMGB1 may play a role in immunopathogenesis of bronchopneumonia with RSV and germ infection;the mechanism of action of HMGB1 may be different compared with TNF-α .