重症药疹患者外周血药物特异性T细胞扩增及干扰素γ产生的研究  

Proliferation of and production of interferon-γ by drug-specific peripheral T cells from pafients with severe drug eruption

作　　者：高杨[1] 付萌[1] 史晓蔚[1] 廖文俊[1] 高琳[1] 高天文[1] 王刚[1] 李承新[1] 刘玉峰[1] 

机构地区：[1]第四军医大学西京医院皮肤科,西安710032

出　　处：《中华皮肤科杂志》2010年第7期478-481,共4页Chinese Journal of Dermatology

摘　　要：目的 检测重症药疹患者外周血中药物特异性T细胞扩增及干扰素γ（IFN-γ）产生情况.方法 共收集10例重症药疹门诊患者,分离患者外周血单一核细胞（PBMC）,经相应的致敏药物刺激后培养出T细胞株,用体外ELISpot和培养ELISpot方法检测患者PBMC及药物特异性T细胞株分泌IFN-γ的情况.对10例患者同时设立与致敏药物分子结构不同的无关药物对照组.结果 重症药疹组中的10例患者PBMC、药物特异性T细胞株经致敏药物刺激后,IFN-γ的分泌明显高于正常对照组（P〈0.01）,且T细胞株经药物刺激后IFN-γ的分泌显著高于PBMC组（P〈0.01）.与致敏药物分子结构不同的无关对照药物不能够使药疹患者PBMC产生IFN-γ,不能培养出相应的T细胞.3例重症药疹患者治愈1～3年后,PBMC中仍存在药物特异性T细胞.结论 重症药疹患者体内存在药物特异性T细胞.体外ELISpot联合培养ELISpot方法在体外检测可能有助于致敏药物的鉴定.药疹患者治愈后体内持续存在药物特异性T细胞.Objective To detect the proliferation of and production of interferon-γ by drug-specific peripheral T cells from patients with severe drug eruption.Methods Peripheral blood mononuclear cells （PBMCs） were isolated from 10 patients with severe drug eruption,10 patients with mild or moderate drug eruption and 10 normal human controls,stimulated with causative drugs to obtain drug-specific T cells.Then,both PBMCs and drug-specific T cells were stimulated with causative drugs or unrelated drugs followed by the detection of secretion levels of IFN-γ with ex vivo enzyme-linked immunodotting （ELISpot） assay and cultured ELlSpot assav respectively.Results After stimulation with causative drugs,a higher level of IFN-γ was secreted by PBMCs and drug-specific T cells from patients with severe drug eruption compared with those from normal human controls （both P〈0.01）.and by drug-specific T cells than by PBMCs （P〈0.01）.The culture with unrelated drugs could neither induce the generation of drug-specific T cells nor promote the secretion of IFN-γ by PBMCs from the patients.Drug-specific T cells still existed in the peripheral blood of 3 patients within 1 to 3 years after recovery of drug eruption.Conclusions There are drug-specific T cells in peripheral blood of patients with severe drug eruption,and they may persist for a certain period of time after recovery of drug eruption.Ex vivo ELISpot combined with cultured ELISpot may be applied to the identification of causative drugs in vivo.

关 键 词：药疹 T淋巴细胞 干扰素Ⅱ型 

分 类 号：R758.25[医药卫生—皮肤病学与性病学]