儿童过敏性哮喘患者中Th17/Treg比值与IDO相关性的研究

Study on the correlation between Th17/Treg ratio and IDO in children with allergic asthma

目的证实儿童过敏性哮喘患者中吲哚胺-2,3-双加氧酶(IDO)可能通过影响Th17/Treg分化及其相关细胞因子参与儿童过敏性哮喘的发病。方法选取该科室门诊5岁以上初次诊断为过敏性哮喘的患儿共33例,33例健康儿童作为对照组;进行肺功能、皮肤点刺试验、嗜酸性粒细胞计数;留取静脉血检测Th17细胞及Treg数目,检测白细胞介素(IL)-10、IL-17、IL-6、转化生长因子-β(TGF-β)水平;静脉血和诱导痰液检测IDO代谢产物色氨酸及犬尿氨酸浓度。结果与对照组比较,哮喘组存在显著的Th17/Treg失衡;IL-17、IL-6水平显著升高,TGF-β、IL-10水平显著降低;IDO水平明显降低,其水平与Th17/Treg比例呈显著负相关关系。结论 IDO可能是Th17细胞向Treg转换的分子"开关",在哮喘发病中起潜在的保护作用。

Objective To demonstrate that IDO may be involved in the development of allergic asthma in children by affecting Th17/Treg differentiation and its related cytokines. Methods Thirty-three children over 5 years old who were diagnosed the first time with allergic asthma were selected from the pediatric outpatient department.Another 33 healthy children were selected as the controls.Pulmonary function test,skin prick test,eosinophil count were taken.Peripheral blood was collected to measure the number and percentage of Th17 and Treg cells and the levels of cytokines,including IL-10,IL-17,IL-6 and TGF-β.Venous blood and induced sputum were used to detect the concentration of tryptophan and kynurenine in IDO metabolites. Results Compared with the control group,there was a significant Th17/Treg imbalance in the asthma group,IL-17,IL-6 levels were significantly increased,TGF-β,IL-10 levels were significantly reduced,IDO levels were significantly reduced,and its levels were negativly associated with Th17/Treg ratio. Conclusion In children with allergic asthma,IDO may stimulate the production of IL-10,inhibit the expression of IL-6,upregulate the level of Treg,and lead to the imbalance of Th17/Treg;Therefore,IDO may be a molecular ＂switch＂ that leads to the conversion of Th17 cells to Treg cells,which plays a potentially protective role in the pathogenesis of asthma.