哮喘患儿诱导痰中T细胞亚群和细胞因子的变化及意义

Changes and the significance of T cell subsets and cytokines in bronchial asthma children sputum

目的:探讨哮喘患儿诱导痰中T细胞亚群和细胞因子的变化及意义。方法:收集86例支气管哮喘患儿,设为观察组;另收集35例健康儿童,作为对照组,检测两者肺功能指标:一秒用力呼气容积(FEV1)/用力肺活量(FVC)的比值(FEV1%)和最大呼气峰流速(PEF),诱导痰中炎症因子:白细胞介素-8(IL-8)、肿瘤坏死因子-ɑ(TNF-ɑ)、白细胞介素-6(IL-6),T细胞亚群:Th1细胞、Treg细胞中的CD8^+CD28^-T细胞和CD4^+CD25^+T细胞、Th2细胞和Th17细胞,T细胞亚群相关细胞因子:干扰素-γ(IFN-γ)、转化生长因子-β(TGF-β)、白细胞介素-4(IL-4)、白细胞介素-17A(IL-17A)。结果 :观察组诱导痰中炎症因子IL-8、TNF-ɑ、IL-6高于对照组,肺功能指标PEF和FEV1%均较对照组降低,差异均有统计学意义(P<0.05);观察组诱导痰中Th1细胞,Treg细胞中的CD8^+CD28^-T细胞和CD4^+CD25^+T细胞数量低于对照组,Th2细胞和Th17细胞数量高于对照组,差异有统计学意义(P<0.05);观察组Th1细胞因子IFN-γ和Treg细胞因子TGF-β表达水平低于对照组,而Th2细胞因子IL-4和Th17细胞因子IL-17A表达水平均高于对照组,差异均具有统计学意义(P<0.05)。结论:哮喘患儿诱导痰中T细胞亚群数量异常,表现为Th2与Th17细胞数量及其相关细胞因子增加,而Th1与Treg细胞数量及其相关细胞因子减少,可能是引起哮喘患儿肺功能下降和气道炎症反应的原因。

Objective： To explore the changes and the significance of T cell subsets and cytokines in bronchial asthma children sputum. Methods： Selected 86 cases of children with bronchial asthma as observation group, collected 35 cases of healthy children as control group, detected the both lung function index： forced expiratory volume in one second （FEV1）/ forced vital capacity （FVC）, the ratio of the （FEV1%） and the maximum peak expiratory flow （PEF）, sputum induction of inflammatory cytokines, interleukin 8 （IL-8）, tumor necrosis factor-α （TNF-α） , interleukin 6 （IL 6）, T cell subgroup： Th1 cells, CD8＋CD28 of Treg cells, T cells and CD4＋ CD25＋ T cells and Thl7 cells and Th2 cells, T cell subsets related cyto- kines： interferon gamma （IFN-γ）, transforming growth factor beta （TGF-β）, interleukin 4 （IL-4）, interleukin-17 a（IL-17a）. Results.. The inflammatory markers induced sputum IL-8, TNF-a, IL-6 in observation group was significantly higher than the control group, pulmonary function index FEV1 and PEF % was decreased significantly comparing with the control group , the difference had statistical significance （P〈0.05）. The sputum Thl cells, CD8＋ CD28 T cells of Treg cells and CD4＋ CD25＋ T ceils content in the observation group was significantly lower than the control group, and Thl7 Th2 cells content was significantly higher than the control group, the difference was statistically significant （P〈0.05）. The expression level of Thl cytokines IFN-β and T reg ceils factor TGF-β in observation group was significantly lower than the control group, while the expression levels of Th2 cytokines IL-4 and Th17 cytokine IL-17a were significantly higher than that of control group, showing significant differences （P〈0.05）. Conclusion; Contents of T cell subsets in induced sputum collected from children with asthma showed increased Th2 and Thl7 cell contents and its related cytokines, while the content of Thl and Treg cells and its related cytokines decreased, which might be the cause of declined lung function and airway inflammation in asthma children.