诱导性调节性T淋巴细胞在支气管哮喘患儿粉尘螨滴剂舌下特异性免疫治疗长期疗效中的作用和意义  

Regulatory T cells for long-lasting effect on asthmatic children caused by dermatophagoides farinae with sublingual immunotherapy

作　　者：李芳[1] 吴晓莉[1] 段国威[1] 王炜[1] 陈会欣 

机构地区：[1]河北医科大学第二医院小儿内科,石家庄050000 [2]唐山市滦县人民医院儿科

出　　处：《中华实用儿科临床杂志》2013年第9期673-675,共3页Chinese Journal of Applied Clinical Pediatrics

基　　金：基金项目：2011年河北省科技支撑计划（10276151）

摘　　要：目的探讨诱导性调节性T淋巴细胞在粉尘螨滴剂舌下特异性免疫治疗（SLIT）长期疗效中的作用和意义。方法选择对粉尘螨过敏的轻度支气管哮喘患儿60例，分为非SLIT组和SLIT组。非SLIT组仅接受药物治疗，而SLIT组在药物治疗基础上予舌下含服“粉尘螨滴剂”治疗，分别在治疗前、治疗1年、治疗结束时及治疗结束后1年时分离2组患儿外周血单个核细胞，予粉尘螨浸出液刺激后检测诱导性调节性T淋巴细胞水平变化；同时留取血清检测粉尘螨特异性IgE水平变化。结果SLIT组患儿诱导性调节性T淋巴细胞水平较非SLIT组增高，并随着SLIT的进程逐渐增高，SLIT结束时达高峰并于SLIT结束1年后仍保持在较高水平；非SLIT组患儿在相应时间点诱导性调节性T淋巴细胞水平的差异无统计学意义（P〉0．05）；2组患儿治疗前后特异性IgE水平差异均无统计学意义（P均〉0．05）。结论SLIT有可能通过上调诱导性调节性T淋巴细胞的功能来诱导免疫耐受；诱导性调节性T淋巴细胞在维持SLIT的长期疗效中可能发挥重要作用。Objective To investigate the role of regulatory T cells for long-lasting effect of the sublingual im- munotherapy（SLIT） in children with allergic asthma caused by dermatophagoides farinae. Methods Sixty children with mild allergic asthma who showed positive skin reaction to dermatophagoides allergen skin test were selected and randomly divided into SLIT group and non-SLIT group. The non-SLIT group received drug therapy only, while the SLIT group received sublingual dermatophagoides farina agent besides drug therapy. The mononuelear cells in the peripheral blood, the regulatory T ceils induced by dermatophagoides farinae stimulator in 2 groups were determined by flow cytometry, as well as the levels of the serum IgE in the blood with specific dermatophagoides farina before treatment, 1 year after treatment, at the end of treatment, and 1 year after treatment. Results The levels of regulatory T cells in the SLIT group were increased,with the treatment of specific immunotherapy it increased further and reached the peak after one- year treatment and the peak level maintained after one year of treatment ,which was not significantly different in the lev- els of regulatory T cells at the same period of time in the non-SLIT group （ P 〉 0.05 ）. Compared with the non-SLIT group, the level of serum IgE had no significant differences between 2 groups before and after treatment （ P 〉 0.05 ）. Conclusion SLIT may induce immune tolerance by up-regulating inductive regulatory T cells , which may be involved in therapeutic mechanisms of the SLIT in the patients with allergic asthma caused by dust mites.

关 键 词：舌下特异性免疫治疗 调节性T淋巴细胞 支气管哮喘 儿童 

分 类 号：R72[医药卫生—儿科]