屋尘螨变应原免疫治疗炎症细胞因子与特异性IgE和IgG4的动态相关分析

Dynamic correlation between inflammatory cytokines and specific IgE＆IgG4 to dermatophagoides pteronyssinus in allergen immunotherapy

目的分析屋尘螨（dermatophagoides pteronyssinus，Der p）的sIgE和sIgG4与炎症细胞因子治疗前后的动态相关性，探讨标准化DerP变应原免疫治疗（allergen immunotherapy，AIT）过程的可能机制。方法选取55例在广州医科大学附属第一医院和珠海市人民医院接受AIT的鼻炎或鼻炎合并哮喘患者，分别在治疗前、治疗后4个月与12个月检测血清IL5、IL-8、IL-10、IL-13、IL-17和肿瘤坏死因子“共6种炎症细胞因子的水平。结果AIT后，Der p sIgE水平曾一度升高，但随之开始下降，随着治疗的进行，Der p sIgG4水平均显著性升高。虽然对55例患者细胞因子AIT前后相比无明显差异，但是进行年龄分组（儿童／成人）和疾病分组（鼻炎／鼻炎合并哮喘）后，AIT后细胞因子水平有组间差异，如IL-5水平儿童组高于成人组，且儿童组治疗12个月比治疗前降低；AIT12个月，鼻炎合并哮喘组IL-5水平较治疗前低（P〈O．05）。Der p sIgE和sIgG4与细胞因子在不同免疫治疗阶段与不同的细胞因子有相关性，特别是sIgG4的升高在不同的免疫治疗阶段与不同的细胞因子的变化有关。结论AIT后sIgG4升高，sIgE降低。且儿童与成人组，鼻炎与鼻炎合并哮喘组的细胞因子变化水平不同，Der p sIgE和sIgG4水平与细胞因子在AIT过程存在一定的相关性，说明sIgE和sIgG4在AIT中反映了机体的免疫状态。

Objective To study the correlation between inflammatory cytokines and the dynamic change of slgE and slgG4 of dermatophagoides pteronyssinus （Der p） during allergen immunotherapy （AIT）. Methods Serum inflammatory cytokines and specific IgE ＆ IgG4 to Der p were analyzed from 55 patients with asthma or combine rhinitis AIT in our hospital and Zhuhai peopler s hospital. In three periods-before treatment, 4 months after AIT and 12 months after AIT, the level of six kinds of inflammatory cytokines：IL-5, IL-8, IL-10, IL 13, IL-17 and TNF-α were detected. Results The levels of slgE to Der p rising at 4 months, then began to decline （12 months） in AIT, Der p slgG4 levels were significantly increased with AIT. There was no significant difference in 6 kinds of inflammatory eytokines before and after AIT while 55 cases of patients, however, the cytokine levels has differences between groups：age group （children/adult） and disease group （rhinitis/rhinitis combine asthma） with AIT. Such as the level of IL-5 in children group was higher than in adult group, and 12 months AIT was lower than before treatment in children group; AIT for 12 months, IL-5 levels lower than before treatment in rhinitis combine asthma group. Der p slgE and slgG4 and inflammatory cytokines in different phases of AIT was associated with various cytokines, especially the rise of slgG4 in different stages of immune associated with the change of cytokines in different. Conclusions Der p sIgG4 was increases, slgE was declining after AIT. There were differences in changes of cytokine levels between children and adults group, rhinitis and rhinitis combine asthma group. There was certain correlation between Der p sIgE^sIgG4 and cytokines in the process of AIT. It shows that Der p sIgE and sIgG4 reflected immune status of AIT in clinic detection.