ECP和IL-4、IL-5与RSV毛细支气管炎发病机制相关性研究

Role of ECP,IL-4 and IL-5 in the pathogenesis of RSV bronchiolitis.

目的 探讨嗜酸细胞阳离子蛋白 (ECP)和IL 4、IL 5在呼吸道合胞病毒 (RSV)毛细支气管炎 (毛支 )发病机制中的作用。方法 采用ELISA法检测 30例RSV毛支血清及鼻咽分泌物 (NPS)中的IL 4、IL 5含量 ,PharmaciaCAP系统检测血清及NPS中的ECP含量 ,并对血液和NPS进行嗜酸细胞 (Eos)计数。结果 ①RSV毛支患儿急性期、恢复期和正常对照组血Eos直接计数及ECP含量均无显著差异 (P >0 0 5 ) ,血清IL 4、IL 5水平急性期显著高于恢复期和正常组 (P <0 0 0 1) ,且血清IL 5恢复期亦明显高于正常组 (P <0 0 5 )。②NPS中ECP、IL 4和IL 5急性期均有明显升高 (P <0 0 1) ,但未找到Eos。③NPS中ECP和IL 4含量与入院评分之间存在相关性 (分别r =0 5 6 3,P =0 0 0 1和r =0 6 6 1,P =0 0 0 1)。结论 ①ECP是反映RSV毛支气道炎症和严重程度的可靠指标。②RSV毛支患儿体内存在TH2细胞的活化 ,提示变态反应参与其发病机制。

Objective To investigate the role of eosinophil cationic protein(ECP),IL-4 and IL-5 in the pathogenesis of the respiratory syncytial virus(RSV)bronchiolitis.Methods The levels of ECP IL-4 and IL-5 in the serum and NPS were determined by means of double-antibody radioimmunoassay and ELISA respectively.Eosinophil counts were calculated in blood and NPS.Results (1)There was no significant difference in ECP level and Eos counts between the patients,either at acute or convalescent phase,and controls(P<0.001).Serum IL-5 level was significantly higher in the convalescent than that in controls(P<0.05).(2)ECP,IL-4 and IL-5 levels increased in acute phase(P<0.01),but no Eos was found in NPS.(3)The levels of ECP and IL-4 in NPS correlated with the clinical score(r=0.563,P=0.001 and r=0.661,P=0.001 respectively).Conclusion (1)ECP was a reliable marker in evaluating the inflammation and the severity of bronchiolitis.(2)T H2 lymphocyte activation existed in RSV bronchiolitis,which indicated that allergic reaction played a role in the pathogenesis of the disease.