鼻咽吸出物IL-4、IL-12和IFN-γ在婴幼儿喘息中的变化及意义

Changes of IL-4,IL-12 and IFN-γ levels in nasopharyngeal aspirates of infants with wheezing

目的通过测定婴幼儿喘息患儿鼻咽吸出物中细胞因子IL-4、IL-12和IFN-γ的水平变化,探讨婴幼儿喘息与机体细胞因子反应类型的关系。方法应用固相夹心ELISA法测定和比较58例婴幼儿喘息和47例无喘息的婴幼儿肺炎鼻咽吸出物IL-4、IL-12和IFN-γ水平变化,同时对急性期和恢复期婴幼儿喘息鼻咽吸出物IL-4、IL-12和IFN-γ水平进行测定和比较。结果与婴幼儿肺炎组[(275.11±30.27)ng/L]、对照组[(253.76±39.9)ng/L]和婴幼儿喘息恢复期组[(260.88±28.07)ng/L]比较,鼻咽吸出物IFN-γ水平在婴幼儿喘息组急性期[(142.55±26.56)ng/L]明显下降(P<0.01),而IL-4水平[分别为(8.51±2.02)ng/L,(3.14±1.16)ng/L,(4.95±1.93)ng/L,(3.28±1.36)ng/L)]和IL-4/IFN-γ(分别为0.068±0.044,0.012±0.004,0.019±0.007,0.014±0.005)比值则明显升高(P<0.05);IL-12在婴幼儿喘息急性期组[(587.24±58.14)ng/L]明显低于肺炎组[(1 322.13±139.74)ng/L](P<0.01),与恢复期组[(580.77±64.32)]ng/L和对照组[(604.02±88.38)ng/L]比较差异无统计学意义(P>0.05)。结论婴幼儿喘息急性期局部主要表现为Th2型细胞免疫反应,鼻咽吸出物IL-4产生明显增加,IFN-γ水平则明显下降,而IL-12在婴幼儿肺炎中产生增加。

Objective To test the levels of IL-4,IL-12 and IFN-γ in nasopharyngeal aspirates（ NPS） of infants with wheezing,and to explore the relationship between the infantile wheezing and the type of cytokine response. Methods The NPS of IL-4,IL-12 and IFN-γ levels were measured by ELISA and compared in 58 cases of acute stage and convalescent stage with infantile wheezing and 47 cases of infantile pneumonia. Results The NPS of IFN-γ levels in acute group[（ 142. 55 ± 26. 56） ng/L] were significantly lower than（ 275. 11 ± 30. 27） ng/L of the infantile pneumonia group,（ 253. 76 ± 39. 9） ng/L in the control group and（ 260. 88 ± 28. 07） ng/L in the recovery group,P〈0. 01; while the IL-4[（ 8. 51 ± 2. 02） ng/L,（ 3. 14 ± 1. 16） ng/L,（ 4. 95 ± 1. 93） ng/L,（ 3. 28 ± 1. 36） ng/L] and the ratio of IL-4 /IFN-γ（ 0. 068 ± 0. 044,0. 012 ± 0. 004,0. 019 ± 0. 007,0. 014 ± 0. 005） were significantly higher（ P〈0. 05）; Compared with the infantile pneumonia group[（ 1 322. 13 ± 139. 74） ng / L],the acute group＇s IL-12 level[（ 587. 24 ± 58. 14） ng / L] in NPS were significantly lower（ P〈0. 01） and no statistical difference with the recovery group[（ 580. 77 ± 64. 32） ng / L]and the control group[（ 604. 02 ± 88. 38） ng / L],P〈0. 05. Conclusion The acute Stage of wheezing in infants are with the Th2-predominant response,increase of IL-4 level,decrease of IFN-γ level in NPS,and IL-12 increase in infantile pneumonia.