支原体肺炎患儿辅助性T淋巴细胞亚群T_H1、T_H2细胞状况

T_H1 and T_H2 cells in children with mycoplasma pneumonia

目的 探讨肺炎支原体肺炎急性期患儿外周血淋巴细胞亚群以及辅助性T淋巴细胞亚群TH1、TH2细胞的改变 ,为免疫治疗的可能性提供依据。方法 采用流式细胞仪技术 (FACS)检测了3 5例支原体肺炎急性期患儿外周血T淋巴细胞亚群以及NK细胞和B细胞 ,同时通过检测分泌细胞因子γ干扰素 (IFN γ)、白细胞介素 4(IL 4)的CD+ 4细胞方法 ,测出相应TH1、TH2细胞的百分比 ,并与2 8例正常儿童进行比较。同时对 3 5例支原体肺炎患儿中的 3 0例进行了血清免疫球蛋白及精制结核菌素 (PPD)皮肤试验。全部患儿均系在我院住院的患儿 ,男 15例 ,女 2 0例 ,年龄 3～ 13岁 ,平均 9岁。对照组男 14例 ,女 14例 ,年龄 3～ 12岁 ,平均 7岁。结果 支原体肺炎患儿急性期外周血CD+ 3 、CD+ 4T细胞百分率为 68 0 0± 6 66及 3 7 86± 5 84,较对照组 63 71± 7 92及 3 4 54± 6 2 3高 ,(P <0 0 5) ;患儿外周血TH1细胞百分率为 14 13± 8 46,对照组为 2 0 77± 6 89,两者差异有非常显著意义 (P =0 0 0 1)。NK细胞及TH1/TH2比值在患儿组降低 (P分别为 <0 0 1和 <0 0 5)。两组间CD8、TH2、B细胞百分率及CD4/CD8比值差异无显著意义。 3 0例患儿之血清免疫球蛋白与同龄正常儿童比较 ,IgG全部正常 ;IgA升高 7例 ;IgM升高 4例。

Objective To Study T lymphocyte subsets, including T H1 and T H2 cells in peripheral blood mononuclear cells (PBMC) of children with mycoplasma pneumonia, understand immunopathogenesis and explore the possibility of immunotherapy of patients with mycoplasma pneumonia Methods Fresh peripheral blood samples of patients from two groups, group 1, mycoplasma pneumonia (MP) group (35 cases, 15 males and 20 females, age range 3 13 years, mean 9 years), and control group consisted of 28 healthy children (14 males and 14 females, age range 3 12 years, mean 7 years) were treated and run through the flow cytometry The data were obtained by using Simultest IMK Lymphcyte software and the percentage of CD + 3, CD + 3CD + 4, CD + 3CD + 8, CD - 3CD + 19 and CD - 3CD + 16+56 cells were counted The percentage of T H1 and T H2 cells were gained through determination of intracellular cytokines IFN γ or IL 4 in CD + 4 cells by flow cytometry The 35 patients with MP were hospitalized at our hospital In addition to fever and cough, all the patents had abnormal X ray findings and/or moist rale on auscultation of the lungs The IgM antibody to Mycoplasma pneumoniae was positive in each patient Immunoglobulins were measured, and PPD skin tests were performed in 30 out of the 35 patients with MP T test and rank sum test by SPSS FOR WINDOWS 10 0 was used for statistical analysis Results The percentage of CD + 3 and CD + 4 T lymphocyte was 68 00± 6 66 and 37 86±5 84, respectively, in MP group, and 63 71±7 92 and 34 54± 6 23 in control group ( P <0 05) The percentage of T H1 cells was 14 13±8 46 in patients and 20 77± 6 89 in normal control group ( P =0 001) The percentage of NK cells was 15 57±12 16 and 20 39±9 64 in MP and control group ( P < 0 01) The ratio of T H1/T H2 in MP group was lower than that in control group ( P <0 05) However the percentage of CD 8, T H2, B cells and CD 4/ CD 8 had no difference between the MP and control groups The levels of IgG, IgA, and IgM in serum were normal in most of patients except for a few patients who had elevated IgA and IgM levels The PPD skin tests were negative in 30 out of 35 patients Conclusion In this study a higher percentage of CD + 3 , CD + 4 T lymphocyte and lower percentage of T H1, NK cells in PBMC of patients with mycoplasma pneumonia were found The ratio of T H1 and T H2 cells in patients was also lower None of thirty patients had positive PPD skin tests Unbalanced cell mediated immunity with a tendency toward T H2 existed in patients with MP Therefore, immunomodulators may be useful in treatment of mycoplasma pneumonia