外周血滤泡调节性T细胞/滤泡辅助性T细胞及相关细胞因子在尘螨变应性哮喘患儿中的变化及意义

Changes and significance of T follicular regulatory cells/T follicular helper cells and related cytokines in peripheral blood of children with dust mite allergic asthma

目的探讨尘螨变应性哮喘患儿外周血滤泡调节性T(T_(FR))细胞/滤泡辅助性T(T_(FH))细胞及相关细胞因子变化,并探讨其临床意义。方法回顾性研究。选取2021年1月至12月江南大学附属医院25例急性发作期尘螨变应性哮喘患儿(哮喘组)和同期16例性别和年龄相匹配的健康体检儿童(健康对照组)作为研究对象。采用流式细胞法检测2组外周血TFR细胞、TFH细胞比例;流式细胞微球芯片捕获法检测2组细胞因子[白细胞介素(IL)-10、IL-21]水平;荧光酶免疫技术检测2组尘螨特异性IgE(sIgE)水平;血细胞分析仪检测外周血嗜酸性粒细胞比例。采用t检验进行组间分析,指标间相关性采用Spearman秩相关分析。结果哮喘组TFR细胞/TFH细胞免疫失衡。与健康对照组比较,哮喘组TFR细胞比例较低[(0.11±0.03)%比(0.13±0.03)%],T_(FH)细胞比例较高[(5.07±1.75)%比(3.80±1.60)%],T_(FR)细胞/TFH细胞比值较低(0.02±0.01比0.05±0.03),差异均有统计学意义(t=2.29、2.30、3.71,均P<0.05)。与健康对照组比较,哮喘组IL-21水平较高[(547.85±195.13)ng/L比(404.94±110.41)ng/L],IL-10水平较低[(10.18±3.49)ng/L比(14.79±5.65)ng/L],差异均有统计学意义(t=2.60、3.15,均P<0.05)。哮喘组T_(FR)细胞/T_(FH)细胞比值与sIgE呈负相关(r=-0.4442,P=0.0261),与嗜酸性粒细胞百分比无相关性(r=-0.1352,P=0.5193)。结论尘螨变应性哮喘患儿存在T_(FR)细胞/T_(FH)细胞亚群失衡,失衡的T_(FR)细胞、T_(FH)细胞及其相关细胞因子IL-10、IL-21可能参与调控哮喘sIgE的生成。

Objective To explore the changes of T follicular regulatory(TFR)cells/T follicular helper(T_(FH))cells and their related cytokines in peripheral blood of children with dust mite allergic asthma,and their clinical significance.Methods A total of 25 children with acute dust mite allergic asthma(the asthma group)in Affiliated Hospital of Jiangnan University from January to December 2021 and 16 age-and sex-matched healthy volunteers(the healthy control group)at the same time were enrolled in the retrospective study.The percentages of peripheral TFR cells and TFH cells of the 2 groups were measured by flow cytometry.The plasma levels of cytokines[interleukin(IL)-10,IL-21]of the 2 groups were assessed by the flow cytometric microsphere-based array technology.The specific IgE(sIgE)levels of dust mites in 2 groups were detected by fluorescence enzyme immunoassay.The percentage of eosinophils in peripheral blood detected by blood cell analyzer.Data between groups were compared by t-test,and the correlation among indicators was analyzed by Spearman rank correlation analysis.Results The asthma group had evident T_(FR) cells/T_(FH) cells immune imbalance.Compared with the healthy control group,the asthma group had a significantly lower TFR cells level[(0.11±0.03)%vs.(0.13±0.03)%],a significantly higher TFH cells level[(5.07±1.75)%vs.(3.80±1.60)%],and a significantly lower ratio of T_(FR) cells/T_(FH) cells(0.02±0.01 vs.0.05±0.03)(t=2.29,2.30,3.71;all P<0.05).Compared with the healthy control group,the asthma group had a significantly higher IL-21 level[(547.85±195.13)ng/L vs.(404.94±110.41)ng/L],and a significantly lower IL-10 level[(10.18±3.49)ng/L vs.(14.79±5.65)ng/L](t=2.60,3.15;all P<0.05).The ratio of T_(FR) cells/T_(FH) cells in asthma group was negatively correlated with sIgE(r=-0.4442,P=0.0261),but not related to the eosinophil percentage(r=-0.1352,P=0.5193).Conclusions Children with dust mite allergic asthma suffer from T_(FR) cells/T_(FH) cells subset imbalance.The imbalanced T_(FR) cells,TFH cells and their related cytokines IL-10 and IL-21 may play a role in regulating the production of asthma sIgE.