麻疹患儿外周血单个核细胞天然免疫受体和细胞因子的变化  

Profiles of innate immune receptors and cytokines in peripheral blood mononuclear cells in children with measles

作　　者：曹凌峰[1] 叶颖子[2] 徐锦[1] 王文婕[2] 谢新宝[2] 朱燕凤[2] 沈军[2] 葛艳玲[2] 浦东波[2] 夏爱梅[2] 徐梦华[1] 王晓红[2] 俞蕙[2] 

机构地区：[1]复旦大学附属儿科医院临床检验中心病毒室,上海201102 [2]复旦大学附属儿科医院感染科,上海201102

出　　处：《中华儿科杂志》2013年第12期898-902,共5页Chinese Journal of Pediatrics

基　　金：教育部＂新世纪优秀人才计划＂（NCET-09-0320）

摘　　要：目的 研究麻疹患儿外周血单个核细胞天然免疫受体和细胞因子的表达及其在麻疹急性感染期的免疫作用.方法 以2009至201 1年复口大学附属儿科医院传染科收治的麻疹患儿为麻疹组,选择儿童保健门诊体检的婴幼儿作为对照组.采用相对定量PCR方法检测麻疹组和正常对照组外周血单个核细胞Toll样受体（toll-like receptors,TLR）2、TLR3、TLR4、TLR7、黑色素瘤分化相关基因5（melanoma differentiation-associated gene-5,MDA-5）、维甲酸诱导基因蛋白Ⅰ（retinoic acidinducible gene Ⅰ,RIG-I）、干扰素α（IFN-α）、IFN-β、白细胞介素10（IL-10）mRNA表达水平,采用ELISA法检测血浆中IFN-α 、IFN-β、IL-10的水平,分析两组间差异.结果 麻疹组98例,对照组59例.麻疹组天然免疫受体TLR2 、MDA-5、RIG-1 mRNA的表达量（1.92±0.70、1.93±0.41、1.86 ±0.28）与对照组（1.90±0.87、1.98 ±0.62、1.79 ±0.69）比较差异无统计学意义（P均＞0.05）,其TLR3、4、7mRNA的相对表达量（2.25 ±0.74、2.05±0.72、2.12±0.29）均明显低于对照组（2.09 ±0.78、1.90±0.75、1.87±0.68）（P均＜0.01）.麻疹患儿IFN-α、IFN-β的mRNA表达量（2.41±1.31、2.47±1.26）均明显低于对照组（2.22 ±0.48、2.35 ±0.64）（P均＜0.01）,IL-10的表达量（2.49±0.58）明显高于对照组（2.62±0.95） （P＜0.001）.麻疹组血浆IL-10浓度在不同热程时[＜5 d组：29.89（25.82～38.15） ng/L,≥5d组：34.55（28.26 ～ 38.70） ng/L]均明显高于对照组[25.15（24.20 ～27.38） ng/L]（P均＜0.05）.结论 TLR3、4、7 mRNA在麻疹患儿外周血单个核细胞中呈低水平表达,IFN-α浓度的降低与麻疹热程有关,而IL-10浓度在感染早期就明显升高,并持续较长时间,提示多种TLRs及其效应细胞因子参与了麻疹的免疫应答过程.Objective The aim of this study was to explore the roles and clinical significance of innate immune receptors and cytokine in children with measles. Method The children with measles hospitalized in the department of infectious diseases, Children＇s Hospital of Fudan University during 2009 - 2011 were enrolled into measles group, while the healthy children examined in well baby clinic were enrolled into control group. The mRNA expression of TLR2/3/4/7, melanoma differentiation-associated gene-5 （MDA-5）, retinoic acid-inducible gene I （RIG-I）, IFN-α/β and IL-10 in peripheral blood mononuclear cells were detected by real-time PCR. The protein levels of IFN-α, IFN- and IL-β in plasma were measured using ELISA. SPSS 13.0 software was applied to analyze the difference between two groups. Result Data from a total of 98 patients in measles group and 59 children in control group were collected. The mRNA expressions of TLR2, MDA-5 and RIG-I had no statistical significance between two groups （ P 〉 0. 05,respectively）. The relative mRNA expressions of TLR3, TLR4, TLR7 in measles group （2. 25 ± 0. 74, 2.05 ±0. 72, 2. 12 ±0. 29） were significantly lower than those in control group （2. 09 ±0. 78, 1.90 ± 0. 75, 1.87 ± 0. 68 ） （ P 〈 0. 01 ; respectively ） . Both IFN-cL and IFN-I5 had significantly decreased mRNA expressions in measles patients （2. 41 ± 1.31,2. 47 ± 1.26） compared with those in controls （2. 22 ±0. 48, 2. 35 ± 0. 64） （P 〈 0. 01 respectively） ; however, IL-10 mRNA levels significantly increased （ 2.49 ± 0. 58 vs. 2. 62 ± 0. 95 ） （P 〈 0. 001 ）. The IL-10 levels in plasma in measles group were significantly higher during the whole period of fever [ 〈5 d group：29.89 （25.82 -38. 15） ng/L and ≥5 d group：34. 55 （28.26 - 38.70） ng/L] than that in control group [ 25.15 （24. 20 - 27.38） ng/L] （P 〈0. 05 respectively）. Conelusion TLR3/4/7 mRNA expression was low in peripheral blood mononuclear cells of measles patients. Levels of IL-

关 键 词：麻疹 免疫 先天 干扰素类 细胞因子类 免疫应答 

分 类 号：R725.1[医药卫生—儿科]