SLIT对过敏性哮喘儿童血清免疫学指标的影响

THE IMPACT OF SUBLINGUAL IMMUNOTHERAPY ON SERUM IMMUNOLOGICAL INDEXES IN CHILDREN WITH ASTHMA

目的 探讨粉尘螨滴剂舌下特异性免疫治疗（SLIT）对过敏性哮喘病儿血清免疫学指标的影响。方法 对62例轻中度过敏性哮喘病儿的临床资料进行回顾性分析。62例病儿按治疗方法分为治疗组32例和对照组30例。两组均给予常规治疗,治疗组在常规治疗基础上给予粉尘螨滴剂舌下含服治疗。于治疗前及治疗1年后,采用荧光酶联免疫法检测两组病儿血清总IgE（TIgE）、户尘螨SIgG4、粉尘螨SIgG4及嗜酸性粒细胞阳离子蛋白（ECP）的水平。结果 治疗前两组各指标差异均无显著性（P〉0.05）。治疗组病儿治疗后户尘螨SIgG4、粉尘螨SIgG4水平升高,ECP水平下降,与治疗前比较差异有显著性（t=2.178~12.707,P〈0.05）,而TIgE水平治疗前后差异无显著性（P〉0.05）。对照组病儿治疗前后各指标差异均无显著性（P〉0.05）。治疗后治疗组病儿户尘螨SIgG4、粉尘螨SIgG4水平与对照组相比差异有显著性（t=6.060、5.582,P〈0.05）,而ECP水平与对照组相比差异无显著性（P〉0.05）。结论 粉尘螨滴剂SLIT对病儿体内免疫状态有明显的调节作用,可诱导产生临床免疫耐受,IgG4水平的改变可能与其治疗机制有关。

Objective To investigate the effects of sublingual immunotherapy （SLIT） with Dermatophagoides Farinae Drops on serum immunological indexes in children with asthma. Methods A retrospective analysis of 62 children with mild moderate allergic asthma were conducted. The sick children were divided into treatment group （n = 32） and control group （n = 30）, a conventional therapy was offered to both groups. For those in the treatment group, SLIT with Dermatophagoides Farinae Drops was added. Before and one year after therapy, serum levels of total IgE （TIgE）, Dermatophagoides pteronyssinus Specific IgG4（D. pt. IgG4）, Derrnatophagoides farinae Specific IgG4 （D.f. IgG4） and Eosinophil cationic protein （ECP） were measured by fluoro- immunoassay. Results Before therapy, the differences of each parameter between the two groups were not significant （P~ 0.05） ; After therapy, the levels of D.pt. IgG4 and D.f. IgG4 antibody of the sick kids in the treatment group elevated, and ECP de dined, the differences were significant compared with that before therapy （t= 2.178-12.707, P 〈0.05）, and TIgE remained un- changed （P〉0.05）. There were no significant differences in the control group before and after treatment in terms of each parame- ter （P〉0.05）. After therapy, the levels of D.pt. IgG4 and D.f. IgG4 in the treatment group were different as compared with that in the control group （t：6.060,5.582;P〈0.05）, and ECP was not （P〉0.05）. Conclusion Sublingual immunotherapy with Dermatophagoides Farinae Drops can obviously regulate the sick kid＇s immune state and induce clinical immune tolerance, the changes of IgG4 level is probably related to its therapeutic mechanism.