变应性鼻炎合并鼻息肉患者免疫治疗前后外周血叉头状转录因子p3与细胞抗原识别受体Vγ亚家族基因表达的特点

Gene expression profile analysis of Foxp3 and T cell receptor Vγ subfamilies in allergic rhinitis with nasal polyps patients

目的研究变应性鼻炎合并鼻息肉(allergic rhinitis with nasal polyps,ARwNP)患者粉尘螨舌下特异性免疫治疗(specific sublingual immunotherapy,SLIT)前后外周血Treg细胞叉头状转录因子p3(forkhead box p3,Foxp3)基因和γδT细胞抗原识别受体(T cell receptor,TCR)Vγ亚家族基因表达的特点。方法18例接受SLIT治疗的ARwNP患者,分别在治疗前和治疗满1年后进行鼻部总症状评分、鼻息肉大小评分,血常规检测外周血嗜酸性粒细胞(eosinophils,Eos)比例,鼻息肉(nasal polyps,NP)组织HE染色检测组织Eos比例,RT-qPCR检测外周血Foxp3与TCR VγⅠ~Ⅲ基因表达水平。8例健康志愿者为对照。结果ARwNP患者SLIT治疗总体有效,治疗前Foxp3水平明显低于对照组(U=30.5,P=0.019),治疗后较治疗前明显升高(W=139,P=0.001);治疗前TCR VγⅠ~Ⅲ水平明显低于对照组(U=35,P=0.039;U=32.5,P=0.027;U=10,P<0.001),治疗后仅VγⅢ较治疗前明显升高(t=3.893,P=0.001);治疗前Foxp3与VγⅢ呈正相关、与外周血Eos比例呈负相关;治疗后Foxp3与VγⅡ、Ⅲ呈正相关、与鼻部总症状评分呈负相关,VγⅢ与外周血Eos比例呈负相关。结论ARwNP患者SLIT治疗1年前后外周血Treg细胞和γδT细胞亚群之间存在着动态平衡,免疫治疗早期症状的改善可能与T细胞免疫的重塑相关。

Objective To analyze the expression profile of Treg′s Foxp3 gene and γδT cell′s T cell receptor Vγ subfamily genes in peripheral blood of allergic rhinitis with nasal polyps(ARwNP)patients before and after specific sublingual immunotherapy(SLIT) with dermatophagoidesfarinae.Methods Eighteen ARwNP patients who underwent SLIT were recruited.Before and one year after SLIT,the total nasal symptom score and nasal polyp size score were recorded,the peripheral blood eosinophil(Eos)ratio was determined by blood routine test,the tissue Eos ratio was detected by hematoxylin-eosin staining,and the gene expression levels of Foxp3 and TCR VγⅠ~Ⅲ in peripheral blood were tested by RT-qPCR.Eight healthy volunteers were recruited as controls.Results SLIT treatment for ARwNP patients was effective.The gene expression level of Foxp3 before the treatment was significantly lower than that of the controls(U=30.5,P=0.019),and it was significantly increased(W=139,P=0.001)after the treatment.The levels of TCR VγⅠ~Ⅲ before the treatment were all significantly lower than those of the controls(U=35,P=0.039;U=32.5,P=0.027;U=10,P<0.001),but only VγⅢ was significantly increased after the treatment(t=3.893,P=0.001).Before the treatment,the level of Foxp3 was positively correlated with VγⅢ and negatively correlated with Eos ratio in peripheral blood.After the treatment,the level of Foxp3 was positively correlated with VγII and Ⅲ and negatively correlated with total nasal symptom score.The level of VγⅢ was negatively correlated with Eos ratio in peripheral blood.Conclusions Treg and γδT cell subsets are probably in a dynamic balance in the peripheral blood of ARwNP patients before and after SLIT treatment for one year.The early improvement of symptoms after SLIT might be related to the remodeling of T cell immunity.