95例SARS患者的Th2细胞因子反应及其临床意义  

Predominance of Th2 Cytokine Response at Acute Phase in 95 Patients with SARS and its Clinical Significance

作　　者：黄嘉凌[1] 段朝晖[2] 罗小红[2] 吴立志[1] 檀卫平[2] 闽军[2] 黄健[2] 刘然义[1] 黄必军[1] 李焱[1] 曾益新[1] 黄文林[1] 

机构地区：[1]中山大学肿瘤防治中心 [2]中山大学第二附属医院,广州510120

出　　处：《中国病毒学》2005年第4期341-345,共5页Virologica Sinica

基　　金：973计划(2003CB514107);教育部攻关项目(教技司[2003]64号);广东省科委攻关项目(2003Z3-E0451);广东省科委攻关项目(粤科社字[2003]263号)

摘　　要：本研究共收集95例罹患严重急性呼吸综合征(SARS)的医护人员的急性期和恢复期血清,用ELISA方法测定血清中白细胞介素2(IL-2)、白细胞介素4(IL-4)、白细胞介素10(IL-10)、干扰素γ(IFN-γ)、肿瘤坏死因子β(TNF β)以及转化生长因子β(TGF-β)水平,用流式细胞仪测定急性期患者外周血CD4+和CD8+T细胞比例.结果显示,SARS患者病程初、中期血清IFN-γ无明显改变;IL-2在起病2月内无显著变化,但在病程3～5个月时降低;IL-4在健康对照和患者均未能测出;TNF-β在SARS感染的1周内和病程第2个月内下降.与上述细胞因子形成对比,患者IL-10以及TGF-β均在发病起即持续升高直至整个病程.这些细胞因子的变化均与激素的使用无关(P＞0.05).SARS患者急性期CD4+T细胞和CD8+T细胞急剧减少.可见,SARS相关冠状病毒感染可引起Th2细胞因子反应,可能损害患者的细胞免疫功能而促进体液免疫,IL-10和TGF-β可能在SARS的发病中起作用.This study was designed to investigate dynamics of cytokines in acute and convalescent patients with Severe acute respiratory syndrome （SARS）. The serum levels of cytokines （IL-2, IL-4, IL-8, interleukin-10, IFN-γ, TNF-β and TGF-β） in 95 healthy workers with SARS in our hospital were measured by ELISA. Phenotypes of peripheral lymphocytes were analyzed by flow cytometry in acute phase, compared with those of healthy volunteers. The results showed that serum level of IFN-γ showed no significant change during the whole period of SARS-CoV attack, and IL-2 level did not changed obviously within the first 2 months but decreased during month 3 and 5, while IL-4 levels were undetectable in both healthy subjects and the patients, and expression of TNF-β was diminished within the first week and the second month. In contrast, IL-10 and TGF-β were continuously overproduced for the entire SARS development. These changes are not correlative with the usage of corticosteroids （P〉0.05）. In patients with SARS at acute phase, CD4^＋ and CD8^＋ T lymphocytes decreased dramatically, compared with that of the normal control people. The results suggest SARS-associated coronavirus elicits Th2 cytokine reaction, which may facilitate induction of humoral immunity but impair cellular immunity in patients with SARS. Prolonged overproduction of IL-10 and TGF-β may play important roles in the pathogenesis in SARS.

关 键 词：SARS 免疫分析 激素 

分 类 号：R511.9[医药卫生—内科学]