基于过敏性疾病和健康儿童的淋巴细胞精细分型病例对照研究

Lymphocyte subsets in allergic and healthy children:A case-control study

背景过敏性疾病的诊断缺乏明确的检测标准,主要依赖于病史,在无过敏原刺激情况下则无临床症状,诊断更加困难,寻找辅助诊断过敏标志物显得非常重要。目的检测过敏儿童淋巴细胞精细分型特征,期望对过敏性疾病的诊断提供新的标志物。设计病例对照研究。方法选择食物和呼吸道过敏儿童作为过敏性疾病组,选择与过敏性疾病组同时期在医院健康体检正常、性别和年龄匹配的儿童为健康对照组。采用流式细胞术分析对其淋巴细胞精细分型进行检测。主要结局指标淋巴细胞精细分型。结果过敏性疾病组30例,平均年龄3.6(0.7~10.6)岁;健康对照组27名,平均年龄4.1(0.8~11)岁。两组年龄、性别差异无统计学意义(P分别为0.616和0.574)。T淋巴细胞精细分型:Th2细胞占效应辅助性T细胞比例和Th2/Th1比值过敏性疾病组高于健康对照组[(31.34±2.52)%vs(20.02±2.05)%,(6.86±1.51)vs(2.73±0.35)],差异均有统计学意义。B淋巴细胞精细分型:成熟B细胞比例及绝对计数、浆母细胞绝对计数、IgE^(+)浆母细胞比例、IgE^(+)记忆B细胞比例,过敏性疾病组均高于健康对照组[(11.53±1.22)%vs(6.02±0.52)%,(1068±107.3)个/μL vs(578.74±58.49)个/μL,(40.71±6.44)个/μL vs(17.08±2.93)个/μL,(8.21±1.33)%vs(1.64±0.53)%,(4.48±0.81)%vs(0.47±0.18)%。结论过敏儿童Th2细胞、IgE^(+)浆母细胞和记忆B细胞比例增高,有潜力作为辅助诊断过敏性疾病的标志物。

Background The diagnosis of allergic diseases lacks definite test criteria and mainly depends on the clinical history.In the absence of allergen stimulation,there are no clinical symptoms,making the diagnosis more difficult.Therefore,it is very important to find auxiliary diagnostic markers for allergic diseases.Objective Detection of lymphocyte subsets in allergic children is expected to provide a new marker for the diagnosis of allergic diseases.Design Case-control study.Methods Children with food allergy and respiratory allergy were selected as the allergic disease group,and healthy children matching with gender and age in the same period were selected as the control group.Lymphocyte subsets was analyzed by flow cytometry.Main outcome measures Lymphocyte subsets.Results The average age of 30 patients in the allergy group was 3.6(0.7-10.6)years,and that of 27 healthy controls was 4.1(0.8-11)years.There was no significant difference in age and gender between the two groups(P value was 0.616 and 0.574).For T lymphocyte subsets,the ratio of Th2 cells/effectors helper T cells and Th2/Th1 ratio in the allergic disease group were higher than those in the healthy control group[(31.34±2.52)%vs(20.02±2.05)%,(6.86±1.51)vs(2.73±0.35)],and the differences were statistically significant.Percentage and absolute count of mature B cells,absolute count of plasmablasts,percentage of IgE^(+)plasmablasts,percentage of IgE^(+)memory B cells in allergic children were higher than those of healthy controls[(11.53±1.22)%vs(6.02±0.52)%,(1,068±107.3)cells perμL vs(578.74±58.49)cells perμL,(40.71±6.44)cells perμL vs(17.08±2.93)cells perμL,(8.21±1.33)%vs(1.64±0.53)%,(4.48±0.81)%vs(0.47±0.18)%].Conclusion The increased percentage of Th2 cells,IgE^(+)plasmablasts and memory B cells in allergic children may be a marker for the diagnosis of allergy.