RSV感染毛细支气管炎患儿外周血单核细胞miR-21和FOXP3的表达关系及意义

Correlation between miR-21 and FOXP3 expression in peripheral blood mononuclear cells of children with RSV-infected bronchiolitis

目的探讨呼吸道合胞病毒(RSV)感染毛细支气管炎患儿外周血单核细胞miR-21和FOXP3的表达关系及意义。方法选择收治的RSV毛细支气管炎患儿94例为病例组,门诊健康体检患儿88例为对照组,检测2组miR-21、FOXP3 mRNA水平,血清白介素-4(IL-4)、白介素-8(IL-8)、白介素-10(IL-10)、干扰素-γ(IFN-γ)、肿瘤坏死因子-α(TNF-α)、高敏C反应蛋白(hs-CRP)水平及CD44、Th17细胞水平。结果病例组MIR-21、FOXP3水平高于对照组,差异有统计学意义(P<0.05);病例组CD44、IL-4、IL-8、IL-10水平高于对照组,差异有统计学意义(P<0.05);病例组TNF-α、hs-CRP、TH17均高于对照组,IFN-γ低于对照组,差异有统计学意义(P<0.05);MIR-21、FOXP3与CD44、IL-4、IL-8、IL-10、TNF-α、hs-CRP、TH17正相关关系明显,与IFN-γ负相关关系明显,差异有统计学意义(P<0.05);发现高水平的MIR-21、FOXP3、TH17均为RSV感染毛细支气管炎患儿发生小儿哮喘的危险因素(P<0.05);FOXP3、TH17两者的AUC相近,皆小于MIR-21+FOXP3+TH17;TH17、MIR-21诊断RSV感染毛细支气管炎的灵敏度、特异度相近(P>0.05),均小于MIR-21+FOXP3+TH17(P<0.05)。结论RSV感染毛细支气管炎患儿外周血单核细胞miR-21、FOXP3水平高表达,引发一系列炎性因子失衡可能是RSV感染毛细支气管炎的发病机制;MIR-21+FOXP3+TH17诊断RSV感染毛细支气管炎具有较高的灵敏度、特异度,值得临床推广应用。

Objective To investigate the correlation and significance of miR-21 and FOXP3 expression in peripheral blood mononuclear cells(PBMCs)of children with bronchiolitis infected with respiratory syncytial virus(RSV).Methods A total of 94 children with RSV-infected bronchiolitis were selected as the case group,and 88 healthy outpatients undergoing physical examination were enrolled as the control group.The levels of miR-21 and FOXP3 mRNA,serum IL-4,IL-8,IL-10,IFN-γ,TNF-α,hs CRP levels and CD44 and Th17 cell levels were detected.Results The levels of MIR-21 and FOXP3 in case group were significantly higher than those in control group(P<0.05).The levels of CD44,IL-4,IL-8 and IL-10 in case group were significantgly higher than those in control group(P<0.05).The levels of TNF-α,hs-CRP,and TH17 in case group were significantgly higher than the control group,while IFN-γlevels were significantly lower than those in control group(P<0.05).Moreover the MIR-21 and FOXP3 were positively correlated with CD44,IL-4,IL-8,IL-10,TNF-α,hs-CRP and TH17,which were negatively correlated with IFN-γ(P<0.05).It was found that high levels of MIR-21,FOXP3 and TH17 were risk factors for asthma in children with RSV-infected bronchiolitis(P<0.05).The AUC of FOXP3 and TH17 were similar,which were less than those of MIR-21+FOXP3+TH17.TH17 and MIR-21 were similar in sensitivity and specificity in diagnosis of RSV-infected bronchiolitis(P>0.05),which were less than those of MIR-21+FOXP3+TH17(P<0.05).Conclusion The expression of miR-21 and FOXP3 in PBMCs of children with RSV-infected bronchiolitis is higher,it may cause a series of inflammatory factor imbalances,which may be the pathogenesis of RSV-infected bronchiolitis.MIR-21+FOXP3+TH17 has high sensitivity and specificity in the diagnosis of RSV-infected bronchitis,which is,therefore,worthy of clinical application.