舌下特异性免疫治疗对尘螨所致AR患者Th1/Th2细胞平衡及p38MAPK信号通路的影响

Effects of sublingual specific immunotherapy on Th1/Th2 cell balance and p38MAPK signaling pathway in AR patients caused by dust mites

目的研究舌下特异性免疫治疗对尘螨所致变应性鼻炎(AR)患者的Th1/Th2细胞平衡和p38MAPK信号通路的影响。方法选取2020年1月-2022年7月江西省信丰县人民医院收治的尘螨所致AR患者60例展开此次研究。根据随机数字表法分为对照组和观察组,每组各30例患者。对照组应用粉尘螨滴剂进行标准化治疗,观察组在对照组标准化治疗的基础上,运用舌下特异性免疫治疗。所有患者均治疗1年,比较两组的鼻部症状总评分(TNSS)、Th1/Th2细胞因子(IL-2、IL-4、IFN-γ)、血清特异性免疫球蛋白E(sIgE)、特异性免疫球蛋白G4(sIgG4)水平差异和p38MAPK信号通路。结果治疗前,两组的TNSS各部分(鼻塞、流涕、鼻痒、喷嚏)评分和总评分、Th1/Th2细胞因子表达、血清sIgE、sIgG4水平无明显差异(P>0.05);治疗后,两组的TNSS各部分评分和总评分均明显降低,且观察组明显低于对照组(P<0.05),两组Th2细胞因子(IL-4)水平均下降,观察组明显低于对照组,Th1细胞因子(IL-2、IFN-γ)水平均升高,观察组明显高于对照组;两组血清sIgE水平均降低,对照组明显高于观察组,两组血清sIgG4水平均上升,对照组明显低于观察组(P<0.05)。结论舌下特异性免疫治疗可以促进尘螨所致AR患者Th1/Th2平衡,改善机体炎症因子水平,调节p38MAPK信号通路,值得临床推广应用。

Objective To investigate the effects of sublingual specific immunotherapy on Th1/Th2 cell balance and p38MAPK signaling pathway in patients with dust mite induced allergic rhinitis(AR).Method Sixty patients with AR caused by dust mites admitted to Xinfeng County People's Hospital in Jiangxi Province from January 2020 to July 2022 were selected for this study.According to the random number table method,they were divided into a control group and an observation group,with 30 patients in each group.The control group received standardized treatment with dust mite drops,while the observation group received sublingual specific immunotherapy on the basis of standardized treatment in the control group.All patients were treated for 1 year,and the differences in total nasal symptom score(TNSS),Th1/Th2 cytokines(IL-2,IL-4,IFN-γ),serum specific immunoglobulin E(sIgE),specific immunoglobulin G4(sIgG4)levels,and p38MAPK signaling pathway between the two groups were compared.Results Before treatment,there was no significant difference in TNSS scores and total scores,Th1/Th2 cytokine expression,serum sIgE,sIgG4 levels between the two groups(P>0.05);after treatment,the TNSS scores of each part and total score in both groups were significantly reduced,and the observation group was significantly lower than the control group(P<0.05).The levels of Th2 cytokines(IL-4)in both groups decreased,and the observation group was significantly lower than the control group.Th1 cytokines(IL-2,IFN-γ),the levels all increased,and the observation group was significantly higher than the control group;the serum sIgE levels in both groups decreased,and the control group was significantly higher than the observation group,the serum sIgG4 levels in both groups increased,while the control group was significantly lower than the observation group(P<0.05).Conclusion Sublingual specific immunotherapy can promote Th1/Th2 balance,improve the level of inflammatory factors in the body,regulate the p38MAPK signaling pathway,and is worthy of clinical promotion and application in AR patients caused by dust mites.