恙虫病患儿Th1/Th2/Th17细胞特征性细胞因子表达研究

Expression of Th1/Th2/Th17 cytokine in pediatric tsutsugamushi disease

目的观察恙虫病患儿Th1/Th2/Th17细胞特征性细胞因子在病程不同时期血清的表达,并探讨其在儿童恙虫病中的作用。方法收集2005年1月至2010年11月于广州市妇女儿童医疗中心住院治疗的恙虫病患儿,参照文献建立儿童恙虫病危重症评分系统。用双抗体夹心酶连免疫吸附(ELISA)法分别测定高评分组(≥5分)和低评分组(<5分)恙虫病患儿急性期(起病7 d内)和恢复期(病程14 d)血清中细胞因子干扰素(IFN)-γ、白细胞介素(IL)-4和IL-17表达水平。选择10例健康体检患儿标本作为对照。结果急性期高评分组和低评分组血清IL-17表达水平与对照组比较显著增高(P<0.01),恢复期高评分组和低评分组血清IL-17表达下降与对照组比较差异无统计学意义(P>0.05);血清IL-4表达水平在急性期和恢复期与对照组比较差异无统计学意义(P>0.05);血清IFN-γ表达水平在恢复期与急性期比较差异无统计学意义(P>0.05)。不同时期血清IL-17表达水平与儿童恙虫病评分呈显著正相关(r=0.92,P=0.031)。结论检测血清中细胞因子IL-17水平对儿童恙虫病病情评估有重要临床应用价值,可作为疗效用预后的监测指标之一。

Objective To investigate the expression of Th1/Th2/Th17 cytokine and its role in pediatric tsutsugamushi disease. Methods To evaluate the severity of tsutsugamushi disease, severity scores were established. The serum concentrations of cytokines IFN-γ/IL-4/IL-17 in higher severity score group and lower severity groups were measured using enzyme-linked immunosorbent assays. Results Compared with control group, the levels of IL- 17 were elevated in all patients in the acute phase （P 〈 0.01 ）, and the down-regulation of IL-17 was observed in the convalescent phases. The change of IL-4 and IFN-γ were not observed in the convalescent phases and acute phases. There was a significant correlation between the concentrations of IL-17 in the acute phase and the severity of disease （r = 0.92）. Conclusion The concentration of serum IL-17 may predict the severity of tsutsugamushi disease in children.