CAJ | 학술논문

目的研究麻疹患儿外周血单个核细胞天然免疫受体和细胞因子的表达及其在麻疹急性感染期的免疫作用.方法以2009至201 1年复口大学附属儿科医院传染科收治的麻疹患儿为麻疹组,选择儿童保健门诊体检的婴幼儿作为对照组.采用相对定量PCR方法检测麻疹组和正常对照组外周血单个核细胞Toll样受体(toll-like receptors,TLR)2、TLR3、TLR4、TLR7、黑色素瘤分化相关基因5(melanoma differentiation-associated gene-5,MDA-5)、维甲酸诱导基因蛋白Ⅰ(retinoic acidinducible gene Ⅰ,RIG-I)、干扰素α(IFN-α)、IFN-β、白细胞介素10(IL-10)mRNA表达水平,采用ELISA法检测血浆中IFN-α 、IFN-β、IL-10的水平,分析两组间差异.结果麻疹组98例,对照组59例.麻疹组天然免疫受体TLR2 、MDA-5、RIG-1 mRNA的表达量(1.92±0.70、1.93±0.41、1.86 ±0.28)与对照组(1.90±0.87、1.98 ±0.62、1.79 ±0.69)比较差异无统计学意义(P均＞0.05),其TLR3、4、7mRNA的相对表达量(2.25 ±0.74、2.05±0.72、2.12±0.29)均明显低于对照组(2.09 ±0.78、1.90±0.75、1.87±0.68)(P均＜0.01).麻疹患儿IFN-α、IFN-β的mRNA表达量(2.41±1.31、2.47±1.26)均明显低于对照组(2.22 ±0.48、2.35 ±0.64)(P均＜0.01),IL-10的表达量(2.49±0.58)明显高于对照组(2.62±0.95) (P＜0.001).麻疹组血浆IL-10浓度在不同热程时[＜5 d组:29.89(25.82～38.15) ng/L,≥5d组:34.55(28.26 ～ 38.70) ng/L]均明显高于对照组[25.15(24.20 ～27.38) ng/L](P均＜0.05).结论 TLR3、4、7 mRNA在麻疹患儿外周血单个核细胞中呈低水平表达,IFN-α浓度的降低与麻疹热程有关,而IL-10浓度在感染早期就明显升高,并持续较长时间,提示多种TLRs及其效应细胞因子参与了麻疹的免疫应答过程.
목적 연구마진환인외주혈단개핵세포천연면역수체화세포인자적표체급기재마진급성감염기적면역작용.방법 이2009지201 1년복구대학부속인과의원전염과수치적마진환인위마진조,선택인동보건문진체검적영유인작위대조조.채용상대정량PCR방법검측마진조화정상대조조외주혈단개핵세포Toll양수체(toll-like receptors,TLR)2、TLR3、TLR4、TLR7、흑색소류분화상관기인5(melanoma differentiation-associated gene-5,MDA-5)、유갑산유도기인단백Ⅰ(retinoic acidinducible gene Ⅰ,RIG-I)、간우소α(IFN-α)、IFN-β、백세포개소10(IL-10)mRNA표체수평,채용ELISA법검측혈장중IFN-α 、IFN-β、IL-10적수평,분석량조간차이.결과 마진조98례,대조조59례.마진조천연면역수체TLR2 、MDA-5、RIG-1 mRNA적표체량(1.92±0.70、1.93±0.41、1.86 ±0.28)여대조조(1.90±0.87、1.98 ±0.62、1.79 ±0.69)비교차이무통계학의의(P균＞0.05),기TLR3、4、7mRNA적상대표체량(2.25 ±0.74、2.05±0.72、2.12±0.29)균명현저우대조조(2.09 ±0.78、1.90±0.75、1.87±0.68)(P균＜0.01).마진환인IFN-α、IFN-β적mRNA표체량(2.41±1.31、2.47±1.26)균명현저우대조조(2.22 ±0.48、2.35 ±0.64)(P균＜0.01),IL-10적표체량(2.49±0.58)명현고우대조조(2.62±0.95) (P＜0.001).마진조혈장IL-10농도재불동열정시[＜5 d조:29.89(25.82～38.15) ng/L,≥5d조:34.55(28.26 ～ 38.70) ng/L]균명현고우대조조[25.15(24.20 ～27.38) ng/L](P균＜0.05).결론 TLR3、4、7 mRNA재마진환인외주혈단개핵세포중정저수평표체,IFN-α농도적강저여마진열정유관,이IL-10농도재감염조기취명현승고,병지속교장시간,제시다충TLRs급기효응세포인자삼여료마진적면역응답과정.
Objective The aim of this study was to explore the roles and clinical significance of innate immune receptors and cytokine in children with measles.Method The children with measles hospitalized in the department of infectious diseases,Children's Hospital of Fudan University during 2009-2011 were enrolled into measles group,while the healthy children examined in well baby clinic were enrolled into control group.The mRNA expression of TLR2/3/4/7,melanoma differentiation-associated gene-5 (MDA-5),retinoic acid-inducible gene I (RIG-I),IFN-α/β and IL-10 in peripheral blood mononuclear cells were detected by real-time PCR.The protein levels of IFN-α,IFN-β and IL-10 in plasma were measured using ELISA.SPSS 13.0 software was applied to analyze the difference between two groups.Result Data from a total of 98 patients in measles group and 59 children in control group were collected.The mRNA expressions of TLR2,MDA-5 and RIG-I had no statistical significance between two groups (P ＞ 0.05,respectively).The relative mRNA expressions of TLR3,TLR4,TLR7 in measles group (2.25 ± 0.74,2.05±0.72,2.12 ±0.29) were significantly lower than those in control group (2.09 ± 0.78,1.90 ± 0.75,1.87 ± 0.68) (P ＜ 0.01 ; respectively).Both IFN-α and IFN-β had significantly decreased mRNA expressions in measles patients (2.41 ± 1.31,2.47 ± 1.26) compared with those in controls (2.22 ±0.48,2.35 ± 0.64) (P ＜ 0.01 respectively) ; however,IL-10 mRNA levels significantly increased (2.49 ± 0.58vs.2.62 ±0.95) (P ＜0.001).The IL-10 levels in plasma in measles group were significantly higher during the whole period of fever [＜5 d group:29.89 (25.82-38.15) ng/L and ≥5 d group:34.55 (28.26-38.70) ng/L] than that in control group [25.15 (24.20-27.38) ng/L] (P ＜0.05 respectively).Conclusion TLR3/4/7 mRNA expression was low in peripheral blood mononuclear cells of measles patients.Levels of IL-10 were significantly raised in the early stage after infection and lasted for a long time,and reduced IFN-α levels in plasma were associated with the fever durations of measles patients.These results indicated that multiple TLRs and cytokines may participate in the immune response after measles virus infection.