哮喘患者全血在尘螨主要过敏原刺激下辅助性T淋巴细胞1/辅助性T淋巴细胞2细胞内细胞因子的表达与偏移  

Shift of Th1/Th2 persistently exposed to house dust mite allergens in whole blood of allergic asthma children

作　　者：邵洁[1] A.Purohit 石学耕[3] 俞善昌[1] 邓伟吾[4] F.de Blay 

机构地区：[1]上海第二医科大学附属瑞金医院儿科 [2]法国Louis Pasteur大学肺和变态反应科 [3]上海第二医科大学生物物理研究室 [4]上海第二医科大学附属瑞金医院肺科

出　　处：《上海医学》2005年第8期637-639,共3页Shanghai Medical Journal

摘　　要：目的对尘螨过敏的哮喘儿童外周全血体外持续给予尘螨主要过敏原Der p和Der f刺激,观察辅助性T淋巴细胞(Th)内细胞因子的表达,探讨过敏原暴露对Th1/Th2偏移的影响。方法选择尘螨皮试阳性的哮喘患者23例,采集全血,体外与尘螨主要过敏原Der p、Der f共同孵育培养8h,以单克隆抗体对T淋巴细胞表面抗原、细胞内白介素(IL)-4,干扰素(IFN)-γ进行标记,应用流式细胞技术检测Th细胞内细胞因子的表达。结果哮喘患者全血体外Der p、Der f持续暴露后(过敏原暴露组),Th0、Th1、Th2表达率分别为(0.83±0.45)%、(10.70±4.42)%、(2.16±1.17)%,非过敏原暴露组Th0、Th1、Th2表达率分别为(0.93±0.52)%、(9.19±3.75)%、(1.67±0.82)%。过敏原暴露组Th2表达率显著高于非过敏原暴露组(P<0.05),而两组Th0、Th1表达率的差异无显著性(P>0.05)。过敏原暴露组因Th2增高,Th1/Th2比例降低,Th1/Th2平衡向Th2偏移,与非过敏原暴露组的差异有显著性(P<0.01)。结论Der p、Der f对Th细胞有明显的选择性,过敏原的持续暴露促进Th2优势表达,Th1/Th2平衡向Th2转化,可能是引起哮喘症状反复和加重的机制之一。因此,过敏原的回避和特异性的脱敏治疗也是哮喘治疗的措施之一,应予以必要的重视。Objective T helper cell subsets Th1/Th2 bias, Th2-dominated inflammation is a cornerstone of asthmatic diathesis. The aim of this study was to determine the balance of Th1/Th2 under the condition of persistently exposed to major antigens Der p and Der f of house dust mites. Methods 23 asthmatic subjects who were allergic to house dust mite major allergens Der p and Der f were included in this study to assess the Th1/Th2 paradigm in whole blood cultures stimulated with Der p and Der f for 8h. Intracellular IL-4 and IFN-γ were detected in CD4^＋ T cells by flow cytometry and stained with monoclonal antibodies. Results The percentage of IL-4-producing CD4^＋ T cells in Der p and Der f stimulated group were （2.16±1.17）%, significantly higher than those in the non-allergen stimulated group[（2.16±1.17）% vs （1.67±0.82）% ,P〈0. 05]. However , the percentage of IFN-γ producing CD4^＋ T cells in Der p and Der f stimulated group were （10.70±4.42）%, no significant difference was observed as compared with the non-allergen stimulated group [（10.70±4.42）% vs （9.19±3.75）%, P〉0.05）. Unexpectedly, Th1/Th2 balance shifted to Th2 was due to overproduction of IL-4. （P〈0.01）. Conclusions In atopic asthmatic subjects who are allergic to Der p and Der f, their whole blood overexposed to the same allergens accelerate an overproduction of IL-4 , which is related to the increased capacity of Th2 cells. Specific allergen exposure has selective effects on Th1/Th2 paradigm, and promotes Th1/Th2 balance shift to Th2, thus allergen play a vital role in facilitating airway inflammation in asthma. （Shanghai Med J, 2005, 28： 637-639）

关 键 词：屋尘螨过敏原 辅助性T淋巴细胞1 辅助性T淋巴细胞2 流式细胞术 辅助性T淋巴细胞 细胞内细胞因子 尘螨过敏 哮喘患者 过敏原 Th1/Th2比例 

分 类 号：R725.6[医药卫生—儿科] R446.113[医药卫生—临床医学]