PPD反应与发作期哮喘患儿ECP IgE及细胞因子表达的关系

Relationship Between PPD Reaction and Serum ECP and IgE Levels and Cytokine Ex-pression in Children with Acute Bronchial Asthma

目的 探讨PPD反应与发作期哮喘患儿ECP,IgE及细胞因子表达的关系。方法 实验分健康对照组和哮喘发作组,均进行结核菌素纯蛋白衍化物(PPD)试验。观察PPD反应与哮喘临床症状、肺通气功能测定。血清ECP、IgE等的关系以及PPD试验后哮喘患儿外周血IFN-γ,IL-4,IL-12P40 mRNA的表达。结果 哮喘患儿PPD阴性者(24/32例)明显多于阳性者(8/32例),且PPD反应阴性患儿哮喘中/重度发作(16/24例)较PPD阳性患儿(2/8例)多,P<0.05。PPD阴性的哮喘患儿血嗜酸性细胞阳离子蛋白(ECP)及IgE较PPD阳性的哮喘患儿明显增高(P<0.05)。哮喘患儿PPD试验后IL-12 P40 mRNA,IFN-γ mRNA无明显变化,而IL-4 mRNA升高较对照组明显(P<0.05),致IFN-γ/IL-4 mRNA比值下降。结论 PPD反应阴性的哮喘患儿可能存在着细胞免疫功能低下。PPD正向免疫刺激作用在哮喘患儿中受到抑制。 [中国当代儿科杂志,2003,5(1):20—22]

Objective To study the relationship between PPD reaction and serum ECP and IgE levels, and cytokines expression in children with acute bronchial asthma. Methods The PPD test was performed, serum levels of ECP and IgE were determined and the expressions of IFN-γ, IL-4 and IL-12 P40 mRNA in the peripheral blood were determined following PPD stimulation in 32 asthmatic children. Eight healthy children served as the controls. Results The number of PPD negative responders (n= 24) were significantly greater than that of PPD positive ones (n= 8). Of the 24 children with negative PPD, 16 (66.7%) had moderate or severe asthma attacks and only 2 cases (25.0%) in the 8 children with positive PPD (66.7% vs 25.0%, P < 0.05). The levels of ECP and IgE were higher in the PPD negative patients than those in the PPD positive patients ( P < 0.05). After PPD stimulation in the asthmatic patients there was no significant change of IL-12 mRNA and IFN-γ mRNA expressions, while IL-4 mRNA expression increased compared with the healthy children ( P < 0.05). Conclusions There might be cellular immunity deficiency in PPD negtive patients. The immunoenhancement effect following PPD stimulation is suppressed in asthmatic patients.