CAJ | 학술논문

目的：观察阿奇霉素对支气管哮喘患儿外周血辅助性T淋巴细胞(Th)9和Th17功能的影响,探讨阿奇霉素的抗感染与免疫调节作用机制。方法选择26例支气管哮喘发作期的患儿为研究对象,17例健康儿童为健康对照组。无菌条件下采用密度梯度离心法获取外周血单个核细胞(PBMC),经植物血凝素(PHA)刺激下体外培养。哮喘组置于不同质量浓度阿奇霉素(0、0.1、1.0、10.0 mg/L)条件下,健康对照组无阿奇霉素干预。培养72 h后收集细胞培养上清液,酶联免疫吸附测定( ELISA)法检测培养上清液中白细胞介素(IL)-4、IL-9、IL-17、IL-23水平。采用 SPSS 17.0软件进行统计学分析。结果1.哮喘组 IL-4、IL-9、IL-17和IL-23分泌水平明显高于健康对照组(t=9.210、3.040、8.965、2.796,P<0.05)；2.阿奇霉素10.0 mg/L组PBMC分泌IL-4和IL-9水平均显著低于阿奇霉素0 mg/L组,差异有统计学意义(P<0.05),而其他各剂量组间差异均无统计学意义( P>0.05)。阿奇霉素10.0 mg/L 组 IL-17、IL-23的分泌水平低于0 mg/L 组和0.1 mg/L 组(P<0.05),其他各组间比较差异均无统计学意义(P>0.05)；3.哮喘组患儿PBMC经不同浓度阿奇霉素干预后分泌IL-9与IL-4水平间无相关性(r=-0．255,P>0.05),哮喘组PBMC分泌IL-17与IL-23水平呈正相关(r=0.64,P<0.05)。结论支气管哮喘患儿Th9和Th17细胞功能增强；阿奇霉素在较高组织浓度(10.0 mg/L)条件下可抑制Th9和 Th17细胞功能,前者与IL-4水平变化无关联,后者与IL-23水平降低关系密切；阿奇霉素在较高浓度条件下有抗感染和免疫调节的作用,抑制哮喘患儿的炎性因子的产生,缓解呼吸道炎症。
목적：관찰아기매소대지기관효천환인외주혈보조성T림파세포(Th)9화Th17공능적영향,탐토아기매소적항감염여면역조절작용궤제。방법선택26례지기관효천발작기적환인위연구대상,17례건강인동위건강대조조。무균조건하채용밀도제도리심법획취외주혈단개핵세포(PBMC),경식물혈응소(PHA)자격하체외배양。효천조치우불동질량농도아기매소(0、0.1、1.0、10.0 mg/L)조건하,건강대조조무아기매소간예。배양72 h후수집세포배양상청액,매련면역흡부측정( ELISA)법검측배양상청액중백세포개소(IL)-4、IL-9、IL-17、IL-23수평。채용 SPSS 17.0연건진행통계학분석。결과1.효천조 IL-4、IL-9、IL-17화IL-23분비수평명현고우건강대조조(t=9.210、3.040、8.965、2.796,P<0.05)；2.아기매소10.0 mg/L조PBMC분비IL-4화IL-9수평균현저저우아기매소0 mg/L조,차이유통계학의의(P<0.05),이기타각제량조간차이균무통계학의의( P>0.05)。아기매소10.0 mg/L 조 IL-17、IL-23적분비수평저우0 mg/L 조화0.1 mg/L 조(P<0.05),기타각조간비교차이균무통계학의의(P>0.05)；3.효천조환인PBMC경불동농도아기매소간예후분비IL-9여IL-4수평간무상관성(r=-0．255,P>0.05),효천조PBMC분비IL-17여IL-23수평정정상관(r=0.64,P<0.05)。결론지기관효천환인Th9화Th17세포공능증강；아기매소재교고조직농도(10.0 mg/L)조건하가억제Th9화 Th17세포공능,전자여IL-4수평변화무관련,후자여IL-23수평강저관계밀절；아기매소재교고농도조건하유항감염화면역조절적작용,억제효천환인적염성인자적산생,완해호흡도염증。
Objective To observe the influence of Azithromycin on helper T lymphocyte 9 cells ( Th9 ) and Th17 in peripheral blood of children with bronchial asthma,and to investigate the immunomodulating effect of Azithro-mycin. Methods Twenty-six asthmatic children were selected as the experimental group,and 17 healthy children as a control group. Peripheral blood mononuclear cells(PBMC)were isolated from venous blood by density gradient cen-tri-fugation under aseptic conditions. PBMC were split by phytohemagglutinin( PHA) in vitro. Different concentrations of Azithromycin (0,0. 1,1. 0,10. 0 mg/L)were added into the cultures in the experimental group. The control group was not interfered with azithromycin. The supematant was collected after 72 h. The levels of interleukin ( IL)-4, IL-9,IL-17 and IL-23 in the supematant were determined by enzyme-linked immunosorbent assay(ELISA). SPSS 17. 0 software was used to analyze data. Results (1) The levels of IL-4,IL-9,IL-17 and IL-23 produced from PBMC of the experimental group were significantly higher than those in the control group(t=9. 210,3. 040,8. 965,2. 796,P<0. 05). (2) The levels of IL-9 and IL-4 in Azithromycin 10. 0 mg/L were significantly lower than those in the Azithromycin 0 mg/L(P<0. 05). But there were no differences among other groups(P>0. 05). The levels of IL-17 and IL-23 of Azithromycin 10 mg/L were lower than those in Azithromycin 0 mg/L and 0. 1 mg/L(P<0. 05),but there were no significant differences among other groups(P>0. 05). (3)IL-9 level was negatively correlated with IL-4 level in the experimental group(r=-0. 255,P>0. 05). The levels of IL-23 and IL-17 secreted by Th17 in asthmatic chil-dren had correlation. The secretion of IL-17 levels rose with the secretion of IL-23 rise(r=0. 64,P<0. 05). Conclu-sions The function of Th9 and Th17 in asthmatic children was enhanced;Azithromycin could restrain the function of Th9 and Th17 at higher tissue concentrations (10. 0 mg/L),the former was unrelated to changes in the secretion of IL-9 levels,and the latter with the secretion of IL-23 levels decreased close. Azithromycin can play a role of immune modulators in higher concentrations,inflammatory cytokines are inhibited in the asthmatic children,and Azithromycin relieves airway inflammation.