手足口病患儿调节性B细胞和TH1/TH2/TH17细胞因子表达水平的动态变化及临床意义

Dynamic changes of regulatory B cells and TH1/TH2/TH17 cytokine expression in children with hand,foot and mouth disease and its clinical significance

目的探讨调节性B细胞(Breg)和TH1/TH2/TH17细胞因子在儿童手足口病(HFMD)中的作用。方法应用流式细胞术检测93例HFMD外周血CTL细胞、NK细胞、Breg细胞和Treg细胞的表达情况,CBA方法分析血清TH1/TH2/TH17细胞因子表达水平。以41例健康儿童为对照。结果 HFMD轻重症组Breg细胞和Treg细胞的表达均显著低于照组(P <0.01),重症组显著低于轻症组(P <0.01);CTL细胞和NK细胞及其颗粒酶B和穿孔素表达水平显著高于对照组(P <0.01),重症组显著高于轻症组(P <0.01)。HFMD血清IFN-γ、TNF-α、IL-6、IL-17A表达水平显著高于对照组(P <0.01),重症组IFN-γ、TNF-α、IL-4、IL-6、IL-10、IL-17A表达水平均显著高于轻症组,上述差异均有统计学意义(P <0.01)。相关性分析显示,Breg与Treg的表达呈正相关(r=0.55,P <0.01);轻症组Breg、Treg与IL-10表达水平呈正相关(r值分别为0.73、0.83,P <0.01)。结论 HFMD Breg细胞表达水平显著减低,TH1/TH2/TH17细胞因子表达水平明显改变,这些变化可能参与HFMD病情进展。

Objective To investigate the role of regulatory B cell( Breg) and TH1/TH2/TH17 cytokines in children with hand,foot and mouth disease( HFMD). Methods Flow cytometry was used to detect the expression of CTL,NK,Breg and Treg cells in peripheral blood of 93 patients with HFMD. Serum Th1/Th2/Th17 cytokine expression levels were analyzed by CBA method. Forty-one healthy children were used as controls. Results The expression of Breg cells and Treg cells in mild and severe HFMD groups was significantly lower than that in light group( P < 0. 01),and that in severe group was significantly lower than that in mild group( P < 0. 01). The levels of granulosin B and perforin in CTL and NK cells were significantly higher than those in control group( P < 0. 01),and those in severe group were significantly higher than those in mild group( P <0. 01). The levels of IFN-γ,TNF-α,IL-6 and IL-17 A in serum of HFMD were significantly higher than those in control group( P < 0. 01),and the levels of IFN-γ,TNF-α,IL-4,IL-6,IL-10 and IL-17 A in severe group were significantly higher than those in mild group,with the differences statistically significant( P < 0. 01). Correlation analysis showed that there was a positive correlation between the expression of Breg and Treg( r = 0. 55,P < 0. 01). Breg and Treg were positively correlated with IL-10 expression in mild disease group( r = 0. 73,r = 0. 83,P < 0. 01). Conclusion The levels of HFMD Breg cells were significantly decreased,and the levels of Th1/Th2/Th17 cytokines were significantly changed,which may be involved in the progression of HFMD disease.