特异性免疫治疗对变应性鼻炎外周血CD4+CD25+T调节细胞的影响及远期疗效的观察  

Effects of Specific Immunotherapy on CD4^+CD25^+ Regulatory T Cells in Patients with Allergic Rhinitis and a 3-Year Prospective Study for Long-Term Efficacy

作　　者：李烁[1,2] 洪海裕[3] 李小敏[4] 高进良[2] 高春生[2] 赵家利[2] 刘邦华[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院耳鼻喉科,湖北武汉430022 [2]广东医学院附属深圳南山医院耳鼻喉科,广东深圳518052 [3]中山大学附属第五医院耳鼻咽喉头颈外科,广东珠海519000 [4]珠海市人民医院耳鼻咽喉头颈外科,广东珠海519000

出　　处：《中山大学学报（医学科学版）》2013年第4期607-612,共6页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：珠海市科技局基金(2011B040102026;2012D0401990021);深圳市科技局基金(201103305);深圳市南山区科技局基金(2010023)

摘　　要：【目的】通过检测变应性鼻炎患者皮下特异性免疫治疗前后外周血CD4+T淋巴细胞表面CD25表达情况的变化及观察相关指标,探讨皮下特异性免疫治疗的机制,评价其远期疗效。【方法】将90例确诊变应性鼻炎患者随机分为免疫治疗组和药物治疗组,每组45例。通过症状评分、使用药物评分和鼻结膜炎相关生活质量调查问卷等评价临床疗效,同时通过流式细胞仪检测外周血CD4+T淋巴细胞表面CD25表达情况。【结果】随着特异性免疫治疗的进行,免疫治疗组与药物治疗组症状评分无统计学差异;而免疫治疗组药物评分要明显低于药物治疗组,鼻结膜炎相关生活质量调查问卷评分要高于药物治疗组,差异有统计学意义。变应性鼻炎患者外周血CD4+CD25+T淋巴细胞比例要低于健康对照组,免疫治疗组治疗3年后比例较治疗前升高,差异有统计学意义。而药物治疗组的比例没有明显提高。【结论】经过3年的特异性免疫治疗后,患者症状控制理想,对症治疗的药物明显减少,生活质量明显提高。这可能与影响CD4+CD25+T调节细胞的功能有关。[Objective] To observe the changes of CD4 ＋CD25 ＋ regulatory T cells in the patients with allergic rhinitis after subcutaneous specific immunotherapy, and to investigate the long-term efficacy and mechanism of subcutaneous specific immunotherapy. [Methods] A total of 90 patients with allergic rhinitis were randomly allocated to receive either specific immunotherapy （SIT group, n = 45） or medical treatment （Control group, n = 45）. Symptom scores, medication scores, and Rhinoconjunctivitis Quality of Life Questionnaire were assessed to evaluate the clinical efficacy. CD4~ CD25~ regulatory T cells were detected by flow cytometry （FCM）. [Results] There was a significant difference in medication scores and no significant difference in symptom scores between the two groups after treatment. The patients in SIT group had lower intake of medication. The SIT group also had a significant improvement in the Rhinoconjunctivitis Quality of Life Questionnaire. CD4~ CD25~ regulatory T cells had a lower proportion in the patients with allergic rhinitis than in the healthy people. The proportion of CD4 ＋CD25 ＋ regulatory T cells had a significant improvement in the SIT group while it had no significant difference in the Control group at 3 years after treatment. [ Conclusion] At 3 years after the specific immunotherapy, the patients with allergic rhinitis had lower intake of medication and a significant improvement in symptom and quality of life. It might be related to the influence of the function of the CD4~CD25~ regulatory T cells.

关 键 词：变应性鼻炎 特异性免疫治疗 CD4+CD25+T调节细胞 鼻结膜炎相关生活质量调查问卷 

分 类 号：R76[医药卫生—耳鼻咽喉科]