特应质对婴幼儿喘息患儿糖皮质激素受体mRNA表达的影响

Effect of atopy on the expressions of glucocorticoidreceptor mRNA in infants with wheezing

目的 研究特应质对婴幼儿喘息患儿外周血单个核细胞(PBMCs)中糖皮质激素受体α mRNA和糖皮质激素受体β mRNA表达水平的影响,为婴幼儿喘息患儿选择性应用糖皮质激素和早期合理干预提供科学依据。方法 选取2019年9月—2021年9月于绍兴市人民医院住院的喘息患儿50例为研究对象,其中特应性体质婴幼儿喘息21例纳入特应质阳性组,其余29例纳入特应质阴性组。另选取同期住院的非喘息患儿25例为对照组。采用实时荧光定量PCR检测糖皮质激素受体α mRNA和糖皮质激素受体β mRNA表达量,采用ELISA法检测血清总IgE(TIgE)水平,采用全自动五分类血细胞分析仪测定外周血嗜酸性粒细胞计数和百分比。结果 对照组、特应质阴性组、特应质阳性组血清TIgE值分别为(7.18±6.64)KU/L、(10.68±9.06)KU/L、(324.85±225.08)KU/L,差异有统计学意义(F=53.402,P<0.05)。对照组、特应质阳性组、特应质阴性组糖皮质激素受体α mRNA表达量、糖皮质激素受体β mRNA表达量及糖皮质激素受体α/β比值比较,差异均有统计学意义(均P<0.05)。特应质阳性组糖皮质激素受体α mRNA表达量显著高于特应质阴性组和对照组,特应质阴性组糖皮质激素受体β mRNA表达量显著高于特应质阳性组和对照组,特应质阳性组糖皮质激素受体α/β比值显著高于特应质阴性组和对照组。婴幼儿喘息患儿外周血嗜酸性粒细胞百分比与糖皮质激素受体α/β比值之间呈正相关(r=0.751,P<0.05)。结论 特应质影响婴幼儿喘息患儿糖皮质激素受体亚型的表达,表现为阳性患儿PBMCs中糖皮质激素受体α mRNA高表达,糖皮质激素受体β mRNA低表达,糖皮质激素受体α/β比值升高。外周血嗜酸性粒细胞百分比与糖皮质激素受体α/β比值之间存在显著正相关。

Objective To study the effect of atopy on expressions of glucocorticoid receptorαandβmRNA in peripheral blood mononuclear cells(PBMCs)in infants with wheezing,and provide a scientific basis for early and rational intervention of selective application of glucocorticoid.Methods Fifty infants with wheezing were selected from Shaoxing People's Hospital from September 2019 to September 2021,then they were divided into atopy positive group(21 cases with family-specific constitution)and atopy negative group(29 cases without family-specific constitution).Twenty-five infants without wheezing were selected as control group.Real-time fluorescence quantitative PCR was used to detect the expressions of glucocorticoid receptorαandβmRNA.ELISA was used to detect the levels of serum total IgE(TIgE).Automatic five-class blood cell analyzer was used to detect the count and percentage of eosinophils in peripheral blood.Results The levels of serum TIgE in control group,atopy negative group,and atopy positive group were(7.18±6.64)KU/L,(10.68±9.06)KU/L,and(324.85±225.08)KU/L,respectively,there was statistically significant difference(F=53.402,P<0.05).There were statistically significant differences in the expressions of glucocorticoid receptorαandβmRNA,and the ratio of glucocorticoid receptorα/βamong control group,atopy negative group,and atopy positive group(P<0.05).The expression of glucocorticoid receptorαmRNA in atopy positive group was higher than those in atopy negative group and control group,the expression of glucocorticoid receptorβmRNA in atopy negative group was higher than those in atopy positive group and control group,the ratio of glucocorticoid receptorα/βin atopy positive group was higher than those in atopy negative group and control group.The percentage of eosinophils in peripheral blood was positively correlated with the ratio of glucocorticoid receptorα/β(r=0.751,P<0.05).Conclusion Atopy affects the expressions of glucocorticoid receptor isoforms,showing high expression of glucocorticoid receptorαmRNA and low expression of glucocorticoid receptorβmRNA,and elevated glucocorticoid receptorα/βratio in peripheral blood in positive children.There is a significant positive correlation between the percentage of eosinophils in peripheral blood and the ratio of glucocorticoid receptorα/β.