中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2009年
22期
1563-1566
,共4页
朱亚非%朱建央%蒋卫平%兰菊红%刘晟%蔡晓红
硃亞非%硃建央%蔣衛平%蘭菊紅%劉晟%蔡曉紅
주아비%주건앙%장위평%란국홍%류성%채효홍
支气管炎%呼吸道合胞病毒%T淋巴细胞,调节性%糖皮质激素类
支氣管炎%呼吸道閤胞病毒%T淋巴細胞,調節性%糖皮質激素類
지기관염%호흡도합포병독%T림파세포,조절성%당피질격소류
Bronchitis%Respiratory syncytial viruses%T-lymphocytes,regulatory%Glucocorticoids
目的 探讨毛细支气管炎(简称毛支)的发病机制与激素治疗.方法 对呼吸道合胞病毒(RSV)阳性的毛支患儿,根据血清总IgE是否增高以及有无湿疹、皮炎等过敏病史,分为特应体质和非特应体质2组,各50例,另选健康对照组25名.毛支患儿按临床评分分为轻、中、重度(18、62、20例);再随机分成激素组(49例)和非激素组(51例).流式细胞仪检测外周血CD4+ CD25+调节性T细胞(Treg)的比例;反转录(RT)-PCR检测Foxp3 mRNA的表达量.结果 CD4+ CD25+ Treg的数量和Foxp3 mRNA表达量:健康对照组、非特应体质组、特应体质组分别为(10.5±1.6)%和0.34±0.11、(8.8±2.2)%和0.26±0.08、(7.6±1.8)%和0.21±0.09,差异均有统计学意义(均P<0.05);轻、中、重组分别为(9.7±1.6)%和0.28±0.08、(7.8±2.1)%和0.24±0.06、(6.7±1.3)%和0.20±0.07(均P<0.05).CD4+ CD25+ Treg数量、Foxp3 mRNA的表达量与临床评分均呈显著负相关(r=-0.62、-0.71,均P<0.01);激素治疗后两者均升高[(9.5±2.1)%和0.33±0.10分别比(8.5±1.8)%和0.27±0.12,P<0.05和<0.01].结论 CD4+ CD25+ Treg和Foxp3 mRNA与RSV毛支气道炎症关系密切,可反映毛支的病情严重程度.激素可促进CD4+ CD25+ Treg的发育和功能.
目的 探討毛細支氣管炎(簡稱毛支)的髮病機製與激素治療.方法 對呼吸道閤胞病毒(RSV)暘性的毛支患兒,根據血清總IgE是否增高以及有無濕疹、皮炎等過敏病史,分為特應體質和非特應體質2組,各50例,另選健康對照組25名.毛支患兒按臨床評分分為輕、中、重度(18、62、20例);再隨機分成激素組(49例)和非激素組(51例).流式細胞儀檢測外週血CD4+ CD25+調節性T細胞(Treg)的比例;反轉錄(RT)-PCR檢測Foxp3 mRNA的錶達量.結果 CD4+ CD25+ Treg的數量和Foxp3 mRNA錶達量:健康對照組、非特應體質組、特應體質組分彆為(10.5±1.6)%和0.34±0.11、(8.8±2.2)%和0.26±0.08、(7.6±1.8)%和0.21±0.09,差異均有統計學意義(均P<0.05);輕、中、重組分彆為(9.7±1.6)%和0.28±0.08、(7.8±2.1)%和0.24±0.06、(6.7±1.3)%和0.20±0.07(均P<0.05).CD4+ CD25+ Treg數量、Foxp3 mRNA的錶達量與臨床評分均呈顯著負相關(r=-0.62、-0.71,均P<0.01);激素治療後兩者均升高[(9.5±2.1)%和0.33±0.10分彆比(8.5±1.8)%和0.27±0.12,P<0.05和<0.01].結論 CD4+ CD25+ Treg和Foxp3 mRNA與RSV毛支氣道炎癥關繫密切,可反映毛支的病情嚴重程度.激素可促進CD4+ CD25+ Treg的髮育和功能.
목적 탐토모세지기관염(간칭모지)적발병궤제여격소치료.방법 대호흡도합포병독(RSV)양성적모지환인,근거혈청총IgE시부증고이급유무습진、피염등과민병사,분위특응체질화비특응체질2조,각50례,령선건강대조조25명.모지환인안림상평분분위경、중、중도(18、62、20례);재수궤분성격소조(49례)화비격소조(51례).류식세포의검측외주혈CD4+ CD25+조절성T세포(Treg)적비례;반전록(RT)-PCR검측Foxp3 mRNA적표체량.결과 CD4+ CD25+ Treg적수량화Foxp3 mRNA표체량:건강대조조、비특응체질조、특응체질조분별위(10.5±1.6)%화0.34±0.11、(8.8±2.2)%화0.26±0.08、(7.6±1.8)%화0.21±0.09,차이균유통계학의의(균P<0.05);경、중、중조분별위(9.7±1.6)%화0.28±0.08、(7.8±2.1)%화0.24±0.06、(6.7±1.3)%화0.20±0.07(균P<0.05).CD4+ CD25+ Treg수량、Foxp3 mRNA적표체량여림상평분균정현저부상관(r=-0.62、-0.71,균P<0.01);격소치료후량자균승고[(9.5±2.1)%화0.33±0.10분별비(8.5±1.8)%화0.27±0.12,P<0.05화<0.01].결론 CD4+ CD25+ Treg화Foxp3 mRNA여RSV모지기도염증관계밀절,가반영모지적병정엄중정도.격소가촉진CD4+ CD25+ Treg적발육화공능.
Objective To explore the pathogenesis of respiratory syncytial viruses (RSV) bronchiolitis and its treatment with glucocorticoids. Methods The pediatric patients with RSV bronchiolitis were divided into an atopic group (n=50) and a non-atopic group (n=50) based on whether there were IgE elevation, eczema and dermatitis. Another 25 normal subjects were chosen as a control group. Divided into mild, medium and severe groups, they were finally randomly divided into hormone (dexamethasone) and non-hormone groups. The proportion of CD4+ CD25+ regulatory T cells (Treg) and the expression of Foxp3 mRNA were tested by flow cytometry and RT-PCR retrospectively. Results The proportion of CD4+ CD25+ Treg and the Foxp3 mRNA expression in the control, non-atopic, and atopic groups reached(10.5±1.6)% and 0.34±0.11,(8.8±2.2)% and 0.26±0.08, (7.6±1.8)% and 0.21±0.09, respectively. There were significant differences among these groups (all P<0.05). The mild, medium and severe bronchiolitis groups reached (9.7±1.6)% and 0.28±0.08, (7.8±2.1) % and 0.24±0.06, (6.7±1.3) % and 0.20±0.07 respectively (all P<0.05). The proportion of CD4+ CD25+ Treg and the expression of Foxp3 showed significantly negative correlations with severity (r=-0.62, -0.71, both P<0.01). That is, they correlated with the severity of disease. The proportion of the CD4+ CD25+ Treg and the expression of Foxp3 mRNA of the hormone group were higher than those of the non-hormone group [(9.5±2.1)% and 0.33±0.10 vs (8.5±1.8)% and 0.27±0.12,P <0.05 and <0.01]respectively. Conclusion CD4+ CD25+ Treg and Foxp3 mRNA are involved in the inflanunafion of bronchiolitis. And the levels of CD4+ CD25+ Treg and Foxp3 mRNA level is an objective indicator of the severity of BSV bronchiolitis. The effect of glucocorticoids upon RSV bronchiolitis may be in part due to the direct enhancement of production and functions of CD4+ CD25+ Treg and Foxp3 mRNA.
