喉乳头状瘤患儿人乳头状瘤病毒感染的免疫功能变化研究

Immune function changes of humanpapillomavirus infection in children with laryngeal papilloma

目的观察喉乳头状瘤患儿感染人乳头状瘤病毒(HPV)的免疫功能变化,探讨HPV感染与免疫功能变化的关系。方法选择浙江省舟山医院和浙江大学附属一院2011年1月-2015年12月52例喉乳头状瘤患儿为观察组及52例健康儿童为对照组,喉乳头状瘤患儿组织HPV及分型采用荧光定量聚合酶链反应法检测,测定血清IgM、IgA和IgG含量及血清IL-10、IL-6、IL-4、TNF-α和IFN-γ水平,测定外周血CD4+、CD3+、CD8+含量。结果 52例患儿中HPV11感染32例,HPV6感染20例;观察组发病时间和HPV病毒载量呈负相关(r=-0.341,P=0.043),两组患儿血清IgM、IgA和IgG含量比较差异无统计学意义;观察组患儿CD4+(29.87±7.83)%和CD3+(59.89±9.78)%均低于对照组(36.41±7.67)%、(67.23±8.24)%,差异有统计学意义(P<0.05);观察组患儿血清IL-6[3.07(2.45~8.34)pg/ml]、IL-4[(2.59±1.43)pg/ml]、TNF-α[2.68(1.47~4.37)pg/ml]和IFN-γ[(4.76±2.68)pg/ml]水平均高于对照组[2.12(1.56~2.67)pg/ml、(1.78±0.73)pg/ml、[1.39(1.06~1.98)pg/ml]、(2.41±0.79)pg/ml],差异有统计学意义(P<0.05)。结论 HPV11型和HPV6型为儿童喉乳头状瘤HPV感染类型,发病时间和HPV病毒载量呈负相关,喉乳头状瘤HPV感染表现为免疫抑制,免疫功能变化主要以细胞免疫改变,细胞因子水平升高。

OBJECTIVE To observe the immune function changes of laryngeal papillomas children with human papilloma virus（HPV）infection,and investigate the relationship between human papilloma virus infection and immune function changes.METHODS A total of 52 cases of laryngeal papilloma tumors children were selected as observation group and 52 cases of healthy children were chosen as control group in Zhoushan Hospital and the First Affiliated Hospital of Zhejiang University from Jan.2011 to Dec.2015.HPV and its genotyping in laryngeal papilloma was assayed by fluorescence quantitative polymerase chain reaction,the serum IgM,IgA and IgG concentrations and serum IL-10,IL-6,IL-4,TNF-αand IFN-γlevels were measured,and the peripheral blood CD4＋,CD3＋,CD8＋content were assayed.RESULTSIn 52 cases of children,HPV11 infection was 32 cases,and HPV6 infection was 20 cases.In observation group,onset time was negatively correlated with HPV viral load（r=-0.341,P=0.043）.The difference of serum IgM,IgA and IgG concentrations in the two groups was not statistically significant.The CD4＋（29.87±7.83）% and CD3＋（59.89±9.78）%in observation group were lower than those of control group（（36.41±7.67）% and（67.23 ± 8.24）%）,and the difference was significant（P〈0.05）.The serum IL-6[3.07（2.45-8.34）pg/ml],IL-4[（2.59±1.43）pg/ml],TNF-α[2.68（1.47-4.37）pg/ml]and IFN-γ[（4.76 ± 2.68）pg/ml]levels of observation group were higher than those of control group of[2.12（1.56-2.67）pg/ml,（1.78±0.73）pg/ml,1.39（1.06-1.98）pg/ml,and（2.41±0.79）pg/ml],and the difference was statistically significant（P〈0.05）.CONCLUSIONThe HPV11 and HPV6types are children laryngeal papilloma HPV infection types.The time of onset is negatively correlated with HPV viral load.Laryngeal papilloma HPV infection has immune suppression,immune function change is primarily cellular immune changed,and cytokine levels increase.