儿童过敏性鼻炎特异性免疫治疗过程中外周血CD4^+调节性T细胞的变化及意义

The change of CD4^+regulatory T cells in Children with Allergic Rhinitis after immunotherapy

目的探讨儿童过敏性鼻炎(allergic rhinitis,AR)的发病及特异性免疫治疗(specific immunotherapy,SIT)的治疗机制。方法采用流式细胞术检测56例AR患者SIT治疗前、治疗1年后外周血中CD4+CD25+CD127lo/-Treg表达水平:采用ELISA法检测血清中IL-10、TGF-β1,并与30例健康儿童进行对比。结果 56例AR患儿SIT治疗前外周血中CD4+CD25+CD127lo/-Treg占CD4+T细胞的百分比为(5.36±1.31)%,显著低于对照组(10.23±2.26)%,P<0.05,但SIT治疗1年后其数值为(9.37±2.15)%,与对照组无明显差异。AR患儿治疗前血清中IL-10值为(3.68±1.21)pg/ml,显著低于对照组的(12.37±2.18)pg/ml,P<0.05;TGF-β1表达水平与对照组比较差异无统计学意义。SIT治疗1年后血清中IL-10水平亦与对照组差异不明显(P<0.05);而TGF-β1表达水平分别为(20.16±4.45)pg/ml及(9.27±2.38)pg/ml,其差异有统计学意义(P<0.05)。结论儿童AR患者外周血中CD4+Treg表达水平低,且存在功能缺陷,导致体内诱导免疫耐受机能不足,SIT治疗可以明显调节免疫免疫细胞的功能。

Objective To explore the change of CD4＋ regulatory T cells and the changes of NK cells、IL-10、TGF-β1 in children with allergic rhinitis after one year specific immunotherapy treatment. This study is also aimed prelim-inarily to the pathogenesis and treatment of SIT in children with AR. Methods The peripheral blood of 56 AR patients and 30 healthy subjects were used to measure the proportion of CD4＋CD25＋CD127lo/-T cell population in CD4＋T cells by flow cytometry and the IL-10、TGF-β1 levels were measured by enzyme-linked immunoabsorbent assay. After one year of SIT, we assayed all these parameters again. Results The population of CD4＋CD25＋CD127lo/- T cells in the peripheral blood of AR patients accounted for （5.36 ＆#177;1.31）% of CD4＋ T lymphocytes, which was significantly lower than that in healthy individuals （10.23＆#177;2.26）%（P＆lt;0.05）. After one year of SIT, the population of CD4＋CD25＋CD127lo/-T cells in pe-ripheral blood of AR patients accounted for （9.37 ＆#177;2.15）% of CD4 ＋ T lymphocytes, closeto the normal level （10.23＆#177;2.26）%（P＆gt;0.05）. The serum IL-10 before treatment from children with AR was significantly lower than that from healthy children （P＆lt; 0.05）; no difference was shown in the serum TGF-β1 level before treatment between children with AR and healthy children （P＆gt;0.05）. After SIT, the serum IL-10 increased and had no difference compared with that from healthy children （P＆lt;0.05）, whereas serum TGF-β1 was significantly increased and higher than that from healthy children （P＆lt;0.05）. Conclusion The CD4＋regulatory T cells in the peripheral blood of AR patients are significantly decreased and its function is defected, which leads to immune regulatory dysfunction in vivo. SIT can improve the function of immune cells.