Th1、Th2免疫应答与小儿常见自身免疫病

Th1,Th2 Immune Response and Commone Autoimmune Diseases in Children

目的 了解常见自身免疫病桥本甲状腺炎 (HT)、幼年型特发性关节炎 (JIA)及系统性红斑狼疮 (SLE)患儿机体Th1、Th2免疫应答状况 ,探讨Th1、Th2应答失常与上述疾病的关系。方法 ELISA法检测患儿和对照组PBMC经ConA刺激后上清液中细胞因子的水平。结果 多数HT患儿IL 4/IFN γ比值低于对照组 (P <0 .0 5)。活动期s JIA患儿IL 4增多 ,与血清IgE含量正相关 (r =0 .765 ,P <0 .0 5) ;关节炎型无此改变。SLE机体患儿IFN γ显著增高 (P <0 .0 5)。结论 HT是Th1细胞介导的器官特异性自身免疫病。s JIA患儿Th2应答占优势 ,而非器官特异性自身免疫病SLE则Th1应答增强 ,但不能仅用Th1或Th2应答增强全面解释其发病机制。

Purpose: To investigate the Th1 and Th2 immune response in children with hashimoto thyroiditis (HT), juvenile idiopathic arhritis (JIA) and systematic lupus erythernatmus (SLE). Methods: The cytokines in supertants of cultured PBMC from children with these autoimmune diseases and normal controls were examined by enzyme-linked immunosorbent assay (ELISA). Results: (1) The ratio of in vitro IL-4/IFN-γ was (0.054 ± 0.029)pg/mL from the 12 HT patients, lower than (0.082 ± 0.033)pg/mL from the normal controls, P<0.05. (2) The production of IL-4 in 10 patients with s-JIA (systematic JIA) was (159.38 ± 55.87)pg/mL, higher than those of normal controls, and correlated positively with serum IgE level (r = 0. 765, P < 0.05). (3) The level of IFN-γ in 7 patients with SLE was (2 401.23 ± 318.64)pg/mL, higher than those in normal controls (1458.00 ± 473.68)pg/mL, P < 0.05. Conclusions: HT is a Th1 cytokines induced autoimmune disease. Th2 cytokines predominated in s-JIA children, while Th1 in SLE. However, the pathogenesis of nob-organ specific autoimmune diseases in children could not be explained simply by Th1 or Th2 cytokines profile predominated among clones.