鄱阳湖区血吸虫病人免疫状态研究Ⅲ血吸虫病人抗体低应答现象初探  

Study on immune status of patients with schistosomiasis japonica in Poyang Lake region Ⅲ Humoral and cellular immune characteristics between Schistosoma japonicum high and low antibody responders

作　　者：李召军 袁敏 季旻珺[2] 谢曙英 吕美云[3] 李宜锋 兰炜明 刘跃民 胡飞 曾小军 李剑瑛 林丹丹 

机构地区：[1]江西省寄生虫病防治研究所,南昌330046 [2]南京医科大学病原生物学系 [3]江西省宜春学院化学与生物工程学院

出　　处：《中国血吸虫病防治杂志》2016年第1期11-17,共7页Chinese Journal of Schistosomiasis Control

基　　金：国家自然科学基金(30960344;81460507);江西省自然科学基金(20122BAB205045)

摘　　要：目的探讨血吸虫粪检虫卵阳性者抗体检测为阴性(以下简称"抗体低应答者")的免疫机制。方法对鄱阳湖血吸虫病流行区142例粪检血吸虫卵阳性病例采用虫卵抗原与成虫抗原包被ELISA检测Ig G抗体,并利用ROC曲线确定抗体高、低应答组;检测、比较两组细胞免疫水平及细胞因子水平。结果共筛查出8名抗体低应答者。高、低应答组各同型抗体水平相比,除SWAP-Ig A(t=-1.588,P>0.1)外,差异均有统计学意义(t=-14.517^-2.866,P均<0.05)。与抗体高应答组相比,抗体低应答组外周血CD3^+T细胞占比略升高,CD4+T与CD8+T细胞占比、CD4+/CD8+比值及CD4+CD25+Treg细胞占比均降低,但差异均无统计学意义(t=-1.72~0.974,P均>0.05)。在SEA或SWAP刺激下,两组人群PBMC分泌的IFN-γ水平和IL-10水平差异亦无统计学意义(t=-2.426~0.216,P>0.05)。结论抗体低应答组与高应答组人群仅见同型抗体水平差异;低感染度者在血吸虫释放抗原物质、形成抗原-抗体复合物后,血液循环中抗体滴度非常低,从而导致难以检出是抗体低应答的原因之一。Objective To explore the immune mechanism of negative results of immune tests of schistosomiasis japonica patients. Methods Totally 142 schistosomiasis patients （positive stool examinations） of Poyang Lake region were tested by ELISA method, and the ROC curve was applied to determine the high and low response of the patients. The levels of cellular immunity and cytokines of high and low responders were compared. Results Totally eight schistosomiasis patients were found as low responders. Besides SWAP-IgA （t=- -1.588, P 〉 0.1 ）, the levels of isotype antibodies were significantly lower in the low responders compared with those in the high responders （t = -14.517 to -2.866, all P 〈 0.05）. In the low responders, the proportion of CD3＋T was increased; and the proportions of CD4＋T, CD8＋T, CD4＋CD25＋Treg, and the ratio of CD4＋/CD8＋ were all decreased, but all of them were not significant （t = -1.72 to 0.974, all P 〉 0.05） compared with those in the high responders. The differences of IFN-γ/and IL-10 between the high and low responders were both not significant （t=-2.426 to 0.216, all P 〉 0.05）. Conclusions There is a significant difference between the high and low responders only in the levels of isotype antibodies. One of the reasons of low response in the immune tests is the much lower antibody level after the antigen-antibody compound is completely formulated.

关 键 词：血吸虫病 免疫应答 细胞免疫 体液免疫 低应答 鄱阳湖区 

分 类 号：R532.21[医药卫生—内科学]