尘螨变应原舌下免疫对变应性鼻炎Th2型免疫反应的影响

Sublingual immunotherapy with dermatophagoides pteronyssinus regarding Th2 immune response in patients with allergic rhinitis

目的探讨尘螨变应原舌下免疫治疗对变应性鼻炎Th2型免疫反应的影响。方法自2016年1月至2017年1月前瞻性收集内蒙古医科大学附属医院收治的变异性鼻炎患者92例,将患者随机分为观察组和对照组,每组各46例。两组均给予常规治疗,观察组在此基础上给予尘螨变应原舌下免疫治疗。观察两组患者治疗前后Th2型免疫反应、鼻部症状视觉模拟评分和变应性鼻-结膜炎相关的生活质量量表评分(RQLQ)。结果两组患者入院时鼻部症状视觉模拟评分和RQLQ评分差异均无统计学意义(P> 0. 05)。3个月后与对照组比较,观察组鼻部症状视觉模拟评分和RQLQ评分显著降低(P <0. 05)。两组患者治疗前白介素-4(IL-4)、白介素-13(IL-13)、干扰素(INF-γ)和免疫球蛋白E(Ig E)、Th1、Th2含量差异均无统计学意义(P> 0. 05)。治疗后观察组IL-4、IL-13、INF-γ、Ig E和Th2均显著低于对照组(P <0. 05),两组患者Th1含量比较无显著差异(P> 0. 05)。结论尘螨变应原舌下免疫治疗可以纠正变应性鼻炎Th2细胞失衡,改善患者临床疗效。

Objective To investigate the effect of sublingual immunotherapy with dermatophagoides pteronyssinus on Th2 immune response in patients with allergic rhinitis.Methods From January 2016 to January 2017,92 inpatients with allergy in our hospital were prospectively enrolled and randomized into observation group(n=46)and a control group(n=46),both with conventional treatment.Moreover,the observation group received sublingual dermatophagoides pteronyssinus immunotherapy.Pre-and posttreatment Th2 type immune response and clinical efficacy were observed.Results The VAS and RQLQ regarding nasal symptoms had no significant differences on admission(P>0.05).Three months later,the observation group had lower VAS and RQLQ than the control group(P<0.05).Pretreatment IL-4,IL-13,INF-γ,IgE and Th2(%)levels for both groups had no significant difference(P>0.05).The observation group had significantly lower posttreatment levels of mentioned immune factors than the control group(P<0.05)except for Th1(P>0.05).Conclusion Sublingual immunization with dermatophagoides pteronyssinus can correct the imbalance of Th2 cells in patients with allergic rhinitis and improve clinical efficacy.