糖皮质激素对哮喘患者Th_1/Th_2类细胞因子水平失衡的影响

Effect of Glucocorticoid on Disbalance of Th_1/Th_2 Cytokines in Asthmatic Patients

目的 为了解糖皮质激素对哮喘患者Th1 /Th2 类细胞因子水平失衡的影响 ,探讨吸入糖皮质激素治疗哮喘的机制。方法 取外周血 ,用ELISA法检测患者治疗前后和对照组血浆IL -4 (白介素 -4 )、IL -12 (白介素 -12 )、IgE的水平 ,并对统计结果进行统计分析。结果 哮喘组治疗后较治疗前血浆IL -4、IgE和PEF(峰值呼气流速 )变异率均下降 (P <0 0 5 ) ;IL -12的浓度升高 ( P <0 0 5 )。哮喘组治疗前血浆IL -4、IgE和PEF变异率均高于对照组 ( P <0 0 1) ;IL -12的浓度低于对照组 ( P <0 0 1)。经布地奈得 (BUD)治疗后 ,IL -4和IgE浓度仍高于对照组 (P <0 0 1,P <0 0 5 ) ;IL -12低于对照组 (P <0 0 5 ) ;PFE变异率与对照组相比无显著性差异。经相关分析 :IL -4同IgE和PEF变异率呈正相关 (r =0 64 ,r =0 5 2 ;P <0 0 5 ,P <0 0 5 ) ;IL -12同IgE和PEF变异率呈负相关 (r =-0 61,r =-0 49;P <0 0 5 ,P <0 0 5 ) ;IL -4同IL -12呈负相关 (r =-0 86,P <0 0 1)。结论 糖皮质激素治疗哮喘的机制可能是抑制TH2 类细胞因子的过度分泌 ,调节TH

Objective To explore the effect of glucocorticoid on disbalance of the Th 1/Th 2 cytokines to investigate the mechanism of treatment of breathing in glucocorticoid in asthmatic patients. Methods The peripheral blood was drawn and the plasma IL-4,IL-12 and IgE of control group and patients were detected by ELISA method before and after glucocorticoid treatment. The results were analysed statistically. Results ⑴In asthmatic group, plasma IL-4 and IgE levels, and PEF variant rate after treatment were lower than those before treatment (P<0.05). Plasma IL-12 level increased after treatment(P<0.05); ⑵In asthmatic group, plasma IL-4 and IgE levels, and PEF variant rate before treatment were higher than those in control group(P<0.01); ⑶ After treatment of breathing in BUD, plasma IL-4 and IgE levels also were higher in asthmatic group than those in control group(P<0.01,P<0.05). Plasma IL-12 level still was lower than that in control group(P<0.05). PEF variant rate was no significant difference after treatment between the two group(P>0.05); and ⑷ Correlation analysis showed that IL-4 level positively correlated with the IgE level and PEF variant rate(r=0.64,r=0.52;P<0.05,P<0.05).The IL-12 level negatively correlated with IgE level and PEF variant rate(r=-0.61,r=-0.56;P<0.05,P<0.05).The IL-4 level negatively correlated with IL-12 level (r=-0.88,P<0.01). Conclusions The mechanism of glucocorticoid treatment on asthmatic patients may suppress excessive secretion of T H2 cytokines, and glucocorticoid can correct disbalance of function existing in Th 1/Th 2.