25-羟基维生素D对儿童甲型流感病毒感染的免疫调节作用

Immunomodulatory effect of 25-hydroxyvitamin D on children with influenza A infection

目的探讨25-羟基维生素D[25(OH)D]在儿童甲型流感病毒感染中的免疫调节作用。方法选取甲型流感患儿32例为甲型流感组,健康儿童32名为正常对照组,采用酶联免疫吸附法(ELISA)检测甲型流感患儿血清25(OH)D,采用流式细胞术检测外周血T、B、NK淋巴细胞绝对数,以及Th1细胞相关细胞因子白介素-2(IL-2)、肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ),Th2细胞相关细胞因子白介素-4(IL-4)、白介素-6(IL-6)、白介素-10(IL-10)水平,比较甲型流感患儿各指标与正常对照组的差异;运用Logistic回归分析探究25(OH)D与T、B、NK细胞绝对数,各细胞因子间的相关性,进一步阐明甲型流感患儿整体免疫状态。结果甲型流感组的IL-6、IL-10、TNF-α、IFN-γ浓度均高于正常对照组(P<0.05),而25(OH)D,IL-2,IL-4水平及T、B、NK细胞绝对数低于正常对照组(P<0.05);IL-10是甲型流感感染的危险因素(OR=1.38,P=0.02),25(OH)D和IL-2是甲型流感的保护因素(OR=0.94、0.02,P=0.01、0.00);25(OH)D与IL-10呈负相关(r=-0.255,P<0.05),与TNF-α呈负相关(r=-0.307,P<0.05)。结论25-羟基维生素D是甲型流感病毒感染的保护因素,应对患儿病程中25(OH)D与免疫功能状态进行追踪,并重视维生素D的合理补充。

Objective To investigate the immunomodulatory effect of 25-hydroxyvitamin D[25(OH)D]in children with influenza A infection.Methods A total of 32 children with influenza A and 32 healthy children were selected.Serum 25(OH)D in children with influenza A was detected by enzyme-linked immunosorbent assays(ELISA),and absolute T,B and NK lymphocytes in peripheral blood were detected by flow cytometry,and the levels of Th1 cell related cytokines interleukin-2(IL-2),tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ),and Th2 cell related cytokines interleukin-4(IL-4),interleukin-6(IL-6),interleukin-10(IL-10).The differences between the indicators of influenza A children and healthy children were compared.Logistic regression analysis was used to explore the correlation between 25(OH)D and the absolute number of T,B,NK cells and cytokines,so as to further clarify the overall immune status of children with influenza A.Results The concentrations of IL-6,IL-10,TNF-α and IFN-γ in influenza A group were higher than those in normal control group(P<0.05),while the levels of 25(OH)D,IL-2,IL-4 and the absolute numbers of T,B and NK cells were lower than those in normal control group(P<0.05).IL-10 was a risk factor for influenza A infection(OR=1.38,P=0.02),and 25(OH)D and IL-2 were protective factors for influenza A infection(OR=0.94,0.02,P=0.01,0.00);25(OH)D was negatively correlated with IL-10(r=-0.255,P<0.05)and TNF-α(r=-0.307,P<0.05).Conclusions 25-hydroxyvitamin D was a protective factor for influenza A infection.25(OH)D and immunological status should be tracked during the course of disease,and should have reasonable supplementation of vitamin D.