布地奈德对支气管哮喘患儿体内Th17细胞的影响及临床意义

Effect of Budesonide on Level of Th17 Cells in Children with Bronchial Asthma

目的探讨布地奈德治疗儿童支气管哮喘对患儿体内Th17细胞的影响,从而指导临床用药。方法收集支气管哮喘患儿60例,轻度组20例,中度组20例和重度组20例,另选健康幼儿15例作为正常对照。使用布地奈德治疗哮喘患儿,分别于治疗前、治疗后4周、治疗后8周和治疗后12周分离各组外周血单个核细胞,采用流式细胞术检测Th17细胞和IL-22+CD4+细胞;采用ELISA检测IL-17和IL-22水平。结果与对照组相比,哮喘患儿体内Th17细胞和IL-22+CD4+细胞及其相关细胞因子IL-17和IL-22明显增加(P<0.05),且增加的程度与病情严重程度相关。使用布地奈德治疗后,哮喘患儿体内IL-17和IL-22水平下降,且下降程度随布地奈德使用时间延长而增加。结论 Th17细胞及其细胞因子在儿童支气管哮喘的发病中起着十分重要的作用,布地奈德可通过抑制Th17细胞产生IL-17和IL-22控制支气管哮喘。

Objective To explore the effect of Budcsonide on level of Thl7 cells in children with bronchial asthma and then to guide clinical medication. Methods Totally 60 children with bronchial asthma were recruited in this research, with 20 in mild group, 20 in moderate group and 20 in severe group. Besides, 15 healthy children were also recruited as control group. Children with bronchial asthma in different groups were treated with Budesonide. Peripheral venous blood samples were collected before or 4 weeks, 8 weeks and 12 weeks after Budesonide treatment, followed by the separation of PBMCs. Numbers of Th17 cells and IL- 22＋ CD4＊ cells were detected by FACS. Levels of IL - 17 and IL - 22 were detected by ELISA. Results Compared with control group, Thl7 cells and IL - 22 ＋ CD4 ＋ cells ere significantly increased in groups of with bronchial asthma. What＇s more, degree of increase was related to the severity of the disease. After Budesonide treatment, levels of IL - 17 and IL - 22 dropped in groups of children with bronchial asthma. And the decreasing degree was related to the length of Budesonide use. Conclusion Thl7 cells and related cytokines play an important role in the pathogenesis of children bronchial asthma. Bronchial asthma could be well controlled by Budesonide though the inhibition of Thl7 cells producing IL - 17 and IL - 22.