儿童过敏性鼻炎和支气管哮喘中周围Th17和调节性T细胞的失衡

Imbalance between peripheral Th17 and regulatory T cells in children with allergic rhinitis and bronchial asthma

目的探讨周围Th17细胞(Th17)和调节性T细胞(Treg)在儿童过敏性鼻炎(AR)与支气管哮喘(BA)中的失衡及临床意义。方法选取单纯过敏性鼻炎(AR组)、单纯支气管哮喘(BA组)及过敏性鼻炎合并支气管哮喘儿童(AR+BA组)为研究对象,每组25例。以同期入院体检的25例健康儿童为对照组。比较4组外周血Th17细胞、Treg细胞水平,对比4组免疫球蛋白E(IgE)、转化生长因子β_1(TGF-β_1)、第1秒用力呼气容积占预计值百分比(FEV_1%)及血清白介素IL-6、IL-17、IL-23、IL-10水平,并分析AR合并BA患儿IgE、FEV1%与Th17、Treg、TGF-β_1、IL-17的相关性。结果 AR组、BA组、AR+BA组外周血Th17细胞、Treg细胞、IgE、TGF-β_1、FEV1%与对照组比较均有显著差异(P<0.05);AR组、BA组、AR+BA组IL-6、IL-17、IL-23均显著高于对照组(P<0.05),且AR+BA组IL-17显著高于AR组、BA组(P<0.05);相关分析显示IgE与Th17、IL-17水平呈正相关,与Treg、TGF-β_1水平呈负相关(P<0.05)。结论儿童过敏性鼻炎和支气管哮喘中Th17与Treg细胞存在失衡,且其表达与IgE、FEV_1%均存在一定相关性。

Objective To investigate the imbalance of peripheral Th17 cells（ Th17） and regulatory T cells（ Treg） in children with allergic rhinitis（ AR） and bronchial asthma（ BA） and its clinical significance. Methods A total of 25 children with simple AR（ AR group）,25 children with simple BA（ BA group） and 25 children with AR complicated with BA（ AR ＋ BA group） were selected. Another 25 healthy children were selected as control group at the same time. The levels of Th17 cells and Treg cells in peripheral blood,immunoglobulin E（ IgE）,transforming growth factor β1（ TGF-β1）,percentage of forced expiratory volume in one second in predicted value（ FEV1%） and levels of serum IL-6,IL-17,IL-23 and IL-10 were compared among four groups. The correlations between IgE,FEV1% and Th17,Treg,TGF-β1,IL-17 in children with AR complicated with BA were analyzed. Results There were significant differences in peripheral blood Th17 cells,Treg cells,IgE,TGF-β1 and FEV1% between AR group,BA group,AR ＋ BA group and the control group（ P〈0. 05）. IL-17 level was significantly higher in AR ＋ BA group than AR group and BA group（ P〈0. 05）. Correlation analysis showed that IgE was positively correlated with levels of Th17 and IL-17,and negatively correlated with Treg and TGF-β1（ P〈0. 05）. Conclusion There is imbalance of Th17 and Treg cells in children with AR and BA. Their expression are correlated with IgE and FEV1%.