脱敏疗法对支气管哮喘患儿外周血Ⅱ型固有淋巴细胞的影响及临床意义

Influence and clinical significance of desensitization therapy on peripheral blood type Ⅱ innate lymphocytes in children patients with bronchial asthma

目的探讨脱敏疗法对支气管哮喘患儿外周血Ⅱ型固有淋巴细胞(ILC2s)的影响和临床意义。方法选取2014年1月至2015年12月该院收治的30例支气管哮喘患儿,随机分为单纯药物治疗组(n=15)和药物联合脱敏治疗组(n=15),同时选取15例健康体检儿童作为对照组,分别用流式细胞术和酶联免疫吸附试验检测治疗前后外周血ILC2s、IL-13、IL-15、IL-33表达水平。结果单纯药物治疗组、药物联合脱敏治疗组外周血ILC2s水平明显高于对照组(P<0.05);单纯药物治疗组治疗1年后外周血ILC2s水平仍高于对照组(P<0.05);药物联合脱敏治疗组治疗2个月后外周血ILC2s水平较治疗前降低(P<0.05),治疗1年后与对照组比较,差异无统计学意义(P>0.05)。单纯药物治疗组、药物联合脱敏治疗组外周血IL-5、IL-13、IL-33水平明显高于对照组(P<0.05);单纯药物治疗组治疗1年后外周血IL-5、IL-13、IL-33水平仍高于对照组(P<0.05);药物联合脱敏治疗组治疗2个月后外周血IL-5、IL-13、IL-33水平较治疗前降低(P<0.05),治疗1年后与对照组比较,差异无统计学意义(P>0.05)。结论脱敏疗法能通过改变支气管哮喘患儿过度活跃的固有免疫应答,使外周血中高表达的ILC2s及细胞因子IL-5、IL-13水平恢复至正常,降低哮喘的气道反应性和炎性反应,达到缓解和治疗哮喘的目的。

Objective To investigate the influence and clinical significance of desensitization therapy on peripheral blood typeⅡinnate lymphocytes(ILC2s)in children patients with bronchial asthma.Methods30children patients with bronchial asthma in this hospital from January2014to December2015were selected and randomly divided into the simple medication treatment group(n=15)and medication combined desensitization treatment group(n=15),meanwhile15healthy children undergoing physical examination were selected as the control group.The flow cytometry and enzyme-linked immunosorbent assay were used to detect peripheral blood ILC2and IL-13,IL-15,IL-33expression levels before and after treatment.Results The peripheral blood ILC2s level in the simple medication treatment group and medication combined desensitization treatment group was significantly higher than that in the control group(P<0.05);the peripheral blood ILC2s level after1-year treatment in the simple medication treatment was still higher than that in the control group(P<0.05);the peripheral blood ILC2s level after2-month treatment in the medication combined desensitization treatment group was decreased compared with before treatment(P<0.05),which had no statistical difference compared with the control group(P>0.05).The peripheral blood IL-5,IL-13and IL-33levels in the simple medication treatment group and medication combined desensitization treatment group were significantly higher than those in the control group(P<0.05).The peripheral blood IL-5,IL-13and IL-33levels after1-year treatment in the simple medication treatment group were still higher than those in the control group(P<0.05);the peripheral blood IL-5,IL-13and IL-33levels after2-month treatment in the medication combined desensitization treatment group were significantly decreased compared with before treatment(P<0.05),and which after1-year treatment had no difference compared with the control group(P>0.05).Conclusion The desensitization therapy can reach the effect for alleviating and treating asthma by changing overactivity innate immune response in children patients with bronchial asthma,making the highly expressed ILC2s,IL-5and IL-13levels to recover to normal levels,and reducing the airway reactivity and inflammatory response.