特异性免疫治疗的相关细胞因子的动态变化及其临床意义

The dynamic change of cytokines associated with the speccific immunotherapy and its clinical significance

目的:探讨特异性免疫治疗(SIT)前后变应性鼻炎(AR)患者体内相关细胞因子的变化规律,寻求评估SIT疗效的一种生物学指标。方法:应用ALK屋尘螨疫苗对100例AR患者进行SIT治疗,分析治疗前、治疗17周及57周血清屋尘螨sIgE、IL-4、IL-5、IL-8、IL-10、IL-13、IL-17、IFN-γ和TNF-α的水平,同时收集患者鼻部症状的综合评分,比较这些免疫指标的差值与鼻部综合评分降幅的相关性。结果:IL-5、IL-8、IL-10、IL-13、IL-17和TNF-α这6种细胞因子的水平在SIT治疗前后均无明显差异。SIT治疗前及治疗57周血清IL-5水平与屋尘螨sIgE水平呈正相关(P<0.05)。治疗前与治疗17周,血清IL-5、IL-17水平的变化与鼻部症状评分降低幅度呈正相关(P<0.01)。治疗17周与治疗57周,血清IL-10、IL-13、TNF-α水平的变化与鼻部症状评分降低幅度呈负相关(P<0.01)。治疗前与治疗57周,血清IL-13、IL-17、TNF-α水平的变化与鼻部症状评分降低幅度呈正相关(P<0.05),血清IL-10水平的变化与鼻部症状评分降低幅度呈负相关(P<0.01)。结论:细胞因子(IL-4、IL-5、IL-8、IL-10、IL-13、IL-17、IFN-γ和TNF-α)在SIT治疗AR的机制中发挥着重要作用,其可客观反映SIT免疫状态。

Objective：This project aimed to study the dynamic change of the cytokines associated with specific immunotherapy（SIT）pre-and post-SIT.Searching for immune regulatory indicators would used in SIT.Method：One hundred cases who had accepted SIT were enrolled in the project.Data of serum specific IgE and cytokines were statistically analyzed.In the three periods,pre-SIT,17 weeks post-SIT,57 weeks post-SIT,the levels of the eight kinds of cytokines（IL-4,IL-5,IL-8,IL-10,IL-13,IL-17,IFN-γand TNF-α）were detected,and the dynamic change of the nasal symptoms score were analyzed.Result：The six kinds of cytokines（IL-5,IL-8,IL-10,IL-13,IL-17 and TNF-α）had no significant difference before and after SIT.The level of house dust mite sIgE level was positively correlated with serum IL-5when the SIT pre-treatment and 57weeks（P〈0.05）.Pre-treatment and in 17 weeks after treatment,serum IL-5,IL-17 content difference and reduce the magnitude of nasal symptom scores were positively correlated（P〈0.01）.In 17 weeks of treatment and 57 weeks of treatment,difference of serum IL-10,IL-13,TNF-αlevelsand the difference of nasal symptom scores were negatively correlated（P〈0.01）.Pretreatment and 57 weeks,difference of serum IL-13,IL-17,TNF-αand the difference of nasal symptom scores were positively correlated（P〈0.05）,serum IL-10 levels of difference between the nose ministry of magnitude lower symptom scores were negatively correlated（P〈0.01）.Conclusion：The cytokines（IL-4,IL-5,IL-8,IL-10,IL-13,IL-17,IFN-γand TNF-α）associated with the SIT play an important role in allergy and can objectively reflect the immune status during SIT.