共刺激分子CD_(40)/CD_(40)L在儿童慢性活动性EB病毒感染中的作用  

Changes of Costimulatory Molecules CD_(40)/CD_(40)L in Children with Chronic Active Epstein-Barr Virus Infection

作　　者：付强[1] 周艳玲[1] 宋晓翔[2] 万申红[1] 毛利平[1] 胡荆江[1] 余孔贵[1] 封其华[2] 

机构地区：[1]华中科技大学同济医学院附属荆州医院儿科,湖北荆州434000 [2]苏州大学附属儿童医院肾脏免疫科,江苏苏州215003

出　　处：《实用儿科临床杂志》2011年第22期1716-1718,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的探讨共刺激分子CD40/CD40L在儿童慢性活动性EB病毒感染(CAEBV)发病机制中的作用。方法选择30例EB病毒(EBV)感染患儿,其中CAEBV患儿、传染性单核细胞增多症(IM)患儿各15例;另选择15例健康儿童作为健康对照组。应用反转录-PCR检测EBV感染患儿及健康儿童外周血单个核细胞(PBMC)CD40mRNA和CD40L mRNA的表达量;应用流式细胞仪检测EBV感染患儿及健康儿童外周血淋巴细胞亚群的变化。结果 1.CAEBV组PBMC CD40mRNA及CD40L mRNA表达量明显升高,与健康对照组及IM组比较差异均有统计学意义(Pa<0.05);IM组PBMC CD40mRNA、CD40L mRNA表达量与健康对照组比较差异均无统计学意义(Pa>0.05)。2.CAEBV组外周血CD3+、CD8+、CD19+CD23+、CD16+56+淋巴细胞明显升高,CD4+、CD4+/CD8+淋巴细胞明显降低,与健康对照组比较差异均有统计学意义(Pa<0.05),与IM组比较差异均无统计学意义(Pa>0.05);IM组外周血CD3+、CD8+、CD19+CD23+、CD16+56+明显升高,CD4+、CD4+/CD8+明显降低,与健康对照组比较差异均有统计学意义(Pa<0.05)。结论共刺激分子CD40/CD40L异常表达及淋巴细胞功能紊乱参与CAEBV的发病,存在免疫功能障碍是CAEBV发病的主要原因之一。Objective To investigate the effect of eostimuiatory molecules CD40/CD40L in the pathogenesis of chronic active epstein - barr virus infection（CAEBV） in children. Methods Thirty patients with epstein - barr virus （EBV） infection were selected,in which CAE- BV patients were 15 cases and infectious mononucleosis （ IM ） patients were 15 cases, and 15 cases of healthy children were selected as healthy control group. Reverse transcription palymerase chain reaction （RT - PCR） was used to detect the expressions of CD40 mRNA and CD40 L mRNA in peripheral blood mononuelear cells（ PBMC ）, and flow cytometry was applied to deteci the level of lymphocyte subsets in peripheral blood. Results 1. The expressions of CD40 mRNA and CD40L mRNA in CAEBV group were significantly elevated,comparod with those in IM group and healthy control group, the differences were statistically significant （ Pa 〈 0.05 ）. The expressions of CD40 mRNA and CD40 L mRNA in IM group had no significant difference,compared with those in health control group （Pa 〉 0. 05 ）. 2. The levels of CD3 ^＋ , CD8^＋ , CD19 ^＋ CD23^＋ ,CD16＋56^＋ lymphocyte in beth CAEBV group and IM group were significantly elevated, CD4 ^＋ , CD4 ^＋/CD8^ ＋ lymphocyte significantly decreased,compared with those in healthy control group,the differences were statistically significant （Pa 〈0. 05 ）. There was no significant difference between CAEBV group and IM group（P, 〉 0.05 ）. Conclusions Costimulatory molecules CD40/CD40L abnormal expression and lymphocyte dysfunction are involved in the pathogenesis of CAEBV in children. Immune dysfunction is one of the main causes of CAEBV pathogenesis.

关 键 词：慢性活动性EB病毒感染 CD40 CD40L 淋巴细胞亚群 

分 类 号：R725.1[医药卫生—儿科]