通络定喘汤干预哮喘儿童IL-4及受体基因多态性临床观察

Efficacy observation of Tongluo Dingchuan decoction on IL-4 and receptor gene polymorphism of asthmatic children

目的:观察通络定喘汤干预急性期哮喘患儿血清白细胞介素-4 (IL-4)与总免疫球蛋白E (TIgE),及IL-4基因启动子区-589位点和白细胞介素-4受体(IL-4R) rs1801275的变化,探讨血清分子水平的变化与基因多态性之间关联性。方法:将90例患儿随机分为两组各45例,对照组予布地奈德联合复方异丙托溴铵治疗,治疗组在对照组基础上予通络定喘汤口服治疗。治疗前后检测血清IL-4与TIgE。全血基因组提取DNA,电泳、纯化,产物测序。返回结果后进行统计。结果:治疗后治疗组血清IL-4、TIgE水平降低,且高于对照组(P<0.05);IL-4-589 C/T和IL-4R rs1801275基因多态性分析,治疗组、对照组均以TT和AA基因型为主,组间差异无统计学意义(P>0.05);等位基因频率以T和A等位基因为主,且组间分布无统计学差异性(P>0.05)。治疗后IL-4水平在TT、AA基因型组下降幅度更高(P<0.05)。结论:通络定喘汤可以降低哮喘儿童血清IL-4、TIgE水平。在IL-4和IL-4R位点的基因型频率上,治疗组和对照组均以TT和AA高表达;治疗后血清IL-4含量在TT和AA基因型组下降幅度更高,提示中药疗效与某种特定基因型有相关性。

Objective:To observe the clinical efficacy of Tongluo Dingchuan decoction on serum IL-4,TIgE,IL-4gene promoter region-589 locus and IL-4R rs1801275 in children with acute asthma, and to approach the correlativity between change of serum molecular level and gene polymorphism. Methods:90 cases of children patients were randomly divided into two groups, 45 cases in each group. The control group was treated with budesonide and compound ipratropium bromide, while the treatment group was treated plus with oral Tongluo Dingchuan decoction on the basis of control group. Samples were collected once respectively before and after treatment. Serum IL-4 and TIgE were detected. DNA was extracted from whole blood genome,which was followed by electrophoresis, purification and product sequencing. After the results were returned, the statistics was made. Results: The levels of serum IL-4 and TIgE of treatment group dececreased after treatment,and higher than those of control group(P < 0.05). For IL-4-589 C/T and IL-4R rs1801275 gene polymorphism, TT and AA genotypes were dominant in treatment group and control group;and compared between two groups, the difference was not statistically significant(P>0.05). The allele frequency was dominated by T and A alleles, and there was no significant difference between two groups in the distribution(P>0.05). IL-4 decreased more significantly in TT and AA genotypes groups after treatment(P < 0.05). Conclusion:Tongluo Dingchuan decoction can decrease serum IL-4 and TIgE of asthmatic children. At the genotype frequencies of IL-4 and IL-4R loci, TT and AA are highly expressed in both treatment group and control group. After treatment, the decrease of serum IL-4 content is higher in TT and AA genotype groups, which prompts that there is a correlativity between the efficacy of traditional Chinese medicine and a specific genotype.