支气管哮喘患者外周血PD-1,IFN-γ,IL-4与Th细胞及T细胞亚群水平表达的临床意义研究

Clinical Significance of the Expression of PD-1,IFN-γ,IL-4,Th Cell and T Cell Subsets in Peripheral Blood of Patients with Bronchial Asthma

目的探讨支气管哮喘患者外周程序性死亡受体1(programmend cell death protein l,PD-1)、干扰素-γ(intorferon-γ,IFN-γ)、白细胞介素-4(interleukin-4,IL-4)与辅助性T细胞(helper-T cell,Th细胞)及T细胞亚群水平表达的临床意义。方法选取2019年9月~2020年9月就诊于西安国际医学中心医院的80例哮喘患者为研究组,另以同期在该院体检的80例健康成人为对照组,采用肺功能仪检测两组研究对象的肺功能指标;ELISA法检测两组研究对象血清PD-1,IFN-γ和IL-4水平;单克隆抗体间接免疫荧光法检测两组研究对象外周血Th细胞和T淋巴细胞亚群占比,比较两组以上指标差异并分析其临床意义。结果与对照组相比,研究组肺功能指标FEV1和FEV1/预计值百分比(fevl%pred)、血清PD-1和IFN-γ水平、外周血Th1细胞占比、Th1/Th2比值、CD8+水平以及CD4^(+)/CD8+比值均显著降低,血清IL-4表达水平和外周血Th2细胞及CD4^(+)水平占比均显著升高,差异均有统计学意义(t=3.221~19.847,均P<0.01),而两组CD3+水平无显著差异(t=1.132,P=0.259)。结论支气管哮喘发作伴随着患者血清PD-1水平降低以及IL-4水平增高,从而抑制了Th1细胞产生IFN-γ,并使得Th1/Th2和CD4^(+)/CD8+平衡状态破坏,各细胞及细胞因子相互制约、相互调节,构成复杂的调节网络,对哮喘的诊断治疗有重要意义。

Objective To investigate the clinical significance of the expression of PD-1,IFN-γ,IL-4,Th cell and T cell subsets in peripheral blood of patients with bronchial asthma.Methods From September 2019 to September 2020,80 patients with asthma in Xi’an International Medical Center Hospital were selected as the study group,and 80 healthy adults who were in the hospital for physical examination during the same period were selected as the control group,with 80 cases in each group.Pulmonary function tester was used to detect the pulmonary function indicators of the two groups of subjects,ELISA method was used to detect serum PD-1,IFN-γand IL-4 levels in the two groups of subjects.Monoclonal antibody indirect immunofluorescence method to detect the proportion of Th cells and T lymphocyte subsets in peripheral blood of two groups of subjects.The differences between the above two groups of indicators were compared and their clinical significance was analyzed.Results Compared with the control group,the pulmonary function indexes FEV1 and FEV1/predicted value percentage(fev1%pred),serum PD-1 and IFN-γlevels,percentage of Th1 cells in peripheral blood,Th1/Th2 ratio,CD8+level and CD4^(+)/CD8+ratio were all significantly reduced,and serum IL-4 expression levels and peripheral blood Th2 cells and CD4^(+)levels accounted for significant(t=3.221~19.847,all P<0.01),while there was no significant difference in CD3+levels between the two groups(t=1.132,P=0.259).Conclusion The bronchial asthma attack was accompanied by a decrease in the serum PD-1 level and an increase in the IL-4 level,thereby inhibiting the production of IFN-γby Th1 cells,and disrupting the balance of Th1/Th2 and CD4^(+)/CD8+.Cells and cytokines restrict and regulate each other,forming a complex regulatory network,which is of great significance for the diagnosis and treatment of asthma.