呼吸道合胞病毒感染致毛细支气管炎患儿Th1/Th2亚群的变化

Changes of Th1/Th2 cell subsets in children with bronchiolitis induced by respiratory syncytial virus infection

目的:探讨毛细支气管炎患儿在呼吸道合胞病毒(respiratory syncytial virus,RSV)感染后,Th1/Th2细胞亚群的变化。方法:选取26例RSV感染的毛细支气管炎患儿,且咳嗽、气喘及呼吸困难症状明显,并可在肺部闻及明显哮鸣音等为急性期组;经治疗后咳嗽、气喘及呼吸困难症状明显缓解,肺部哮鸣音减少或消失的18例患儿为恢复期组;同期20例外科住院年龄相仿的疝气择期手术患儿为对照组。应用流式细胞术检测各组患儿外周血单个核细胞(peripheral blood mononuclear cell,PBMC)的IFN-γ和IL-4表达水平,RT-PCR检测各组PBMC中T-bet的变化。结果:与对照组相比,毛细支气管炎患儿急性期IFN-γ水平显著降低,IL-4水平明显增高(P均<0.05);与急性期比较,恢复期患儿IFN-γ水平升高而IL-4明显下降(P均<0.05)。Th1特征性转录因子T-bet在毛细支气管炎患儿急性期表达减少,恢复期呈现增高趋势。结论:RSV感染致毛细支气管炎患儿Th1/Th2细胞亚群分泌的细胞因子失衡,T-bet表达减少,Th2细胞占优势,其变化趋势以急性期为明显。

Objective:To investigate the changes of Th1/Th2 cell subsets in children with bronchiolitis after respiratory syncytial virus(RSV)infection.Methods:26 cases of children with bronchiolitis by RSV infection as the group of bronchiolitis in acute stages,which clinical manifestations of cough,wheezing and dyspnea were obvious.After treatment,the symptoms of cough,wheezing and dyspnea were significantly relieved,and the wheezing in lungs sound decreased or disappeared,these 18 cases as the recovery group.In the same period,20 cases of surgically treated patients with hernia were selected as the control group.The expression levels of IFN-γand IL-4 in peripheral blood mononuclear cells(PBMC)were detected by flow cytometry and the expression of T-bet in PBMC was detected by RT-PCR.Results:Compared with the control group,significant reduction in IFN-γin 26 children with bronchiolitis(P<0.05),and IL-4 is significantly higher(P<0.05).IFN-γincreased in convalescent period,while IL-4 decreased(both P<0.05).The expression of Th1 characteristic transcription factor T-bet was decreased in the acute phase of children with bronchiolitis,and showed an increasing trend in convalescent period.Conclusion:Unbalanced cytokines expression by Th1/Th2 cell subsets have been found in children with bronchiolitis by RSV infection.The expression of T-bet was decreased,Th2 cells were dominant,the trend of change was significantly correlated to the acute stage of the disease.