特异性免疫治疗对变应性鼻炎患者外周血中Th9细胞分化及转录因子表达的影响  

Effect of specific immunotherapy on the differentiation and the expression of related transcription factors of Th9 cells in PBMC of patients with allergic rhinitis

作　　者：曾宪海[1] 赵九洲[1,2] 周才杰[1,3] 李娟娟[1] 赵海亮[1] 邱书奇[1,3] 

机构地区：[1]深圳市龙岗中心医院耳鼻咽喉科医院,广东深圳518172 [2]遵义医学院(珠海校区),广东珠海519041 [3]深圳市耳鼻咽喉研究所,广东深圳518172

出　　处：《中国耳鼻咽喉头颈外科》2013年第5期258-262,共5页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的观察变应性鼻炎(AR)患者变应原特异性免疫治疗(specific immunotherapy,SIT)前、后外周血单个核细胞(peripheral blood mononuclear cells,PBMC)中Th9细胞分化因子及相关转录因子GATA-3、PU.1、IRF4 mRNA表达的变化。方法采用视觉模拟量表(visual analogue scale,VAS)评估71例AR患者(实验组)症状严重程度。流式细胞术检测36例AR患者PBMC中Th9细胞百分率,ELISA法检测血清特异性IgE(specific IgE,sIgE)、特异性IgG4(specific IgG4,sIgG4)、白细胞介素9(interleukin-9,IL-9)和IL-10水平在治疗前及治疗1、2年后变化,对鼻部症状计分。并取32例健康者血清作为对照组。用实时荧光定量PCR法检测实验组与对照组PBMC中Th9细胞相关转录因子GATA-3、PU.1和IRF4mRNA表达水平。结果①AR患者治疗前,PBMC中Th9细胞百分率明显高于对照组(P<0.01),而治疗1、2年后Th9细胞百分率均明显低于治疗前(P<0.01)。②AR患者治疗前,血清sIgE及Th9细胞中IL-9水平高于对照组(P均<0.01),而sIgG4及IL-10水平低于对照组(P均<0.01);治疗1、2年后sIgE和IL-9均低于治疗前(P均<0.01),而治疗2年后,sIgG4和IL-10水平均低于治疗1年后,但高于治疗前(P均<0.01),治疗2年后sIgE水平高于治疗1年后(P<0.01)。③治疗前、后各组GATA-3mRNA表达量与对照组相比均无显著差异(P>0.05),治疗前PU.1、IRF4 mRNA表达量均高于对照组(P均<0.01),而治疗1、2年后PU.1、IRF4 mRNA表达量均低于治疗前(P均<0.01)。结论 SIT可能通过抑制Th9细胞分化,调节相关转录因子的表达而调节机体免疫状态,诱导免疫耐受。OBJECTIVE To investigate the changes of differentiation cytokines and related transcription factors of Th9 cells in the peripheral blood of patients with allergic rhinitis after specific immunotherapy. METHODS The visual analogue scale CVAS） was used to assess the severity of patients with allergic rhinitis. The differentiation percentage of Th9 cells in the peripheral blood mononuclear cells （PBMC） of 36AR patients was analyzed by flow cytometry. The levels of serum specific IgE, IgG4, IL-9 and IL-10 were detected by double-antibody sandwich enzyme-linked immunosorbent assay before and after specific immunotherapy （SIT） one and two years later. And the nasal symptom score （NSS） was evaluated. At the same time, 32 healthy subjects were enrolled as normal control grouts. RESULTS 1. The percentage of Th9 cells in the peripheral blood of AR patients was higher than that of control group （P〈 0.01） . And the percentage in AR patients taken specific immunotherapy after one or two years was lower than that in pre-immunotherapy patients （P〈 0.01） . 2. The levels of serum slgE and IL-9 in Th9 cells in pre immunotherapy AR patients were higher than that in normal group （P〈0.01） . Whereas, the levels of serum slgG4 and IL-10 in pre-immunotherapy AR patients were lower than that in normal group （P 〈 0.01） . The levels of slgE and IL-9 in patients after one and two years specific immunotherapy were lower than that inpre-immunotherapy AR patients （P〈 0.01） . While the levels of slgG4 and IL-10 in patients after two year specific immunotherapy were lower than that after one year （P 〈 0.01 ） , and they was higher than pre-immunotherapy （P〈 0.01） . Meanwhile, the level of slgE in patients after two years specific immunotherapy were higher than that after one year （P〈 0.01） . 3. There were no significant differences in the expression of GATA-3 mRNA among preimmunotherapy, post-immunotherapy and control group （P〉0.05） . The expressions of PU.1 and IRF4 mRNA i

关 键 词：免疫疗法 CD4阳性T淋巴细胞 转录因子 TH9细胞 变应性鼻炎 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]