共刺激分子CD40在儿童嗜酸性粒细胞性胃肠炎中的作用及其机制探讨  

The role of costimulatory molecule CD40 in childhood eosinophilic gastroenteritis and its mechanism

作　　者：付强[1,2] 封其华[3] 余孔贵[1] 唐临飞[1] 李爱民[1,2] 

机构地区：[1]荆州市中心医院儿科,湖北荆州434000 [2]长江大学儿科研究所,湖北荆州434000 [3]苏州大学附属儿童医院肾脏免疫科,江苏苏州215003

出　　处：《临床儿科杂志》2018年第1期5-8,共4页Journal of Clinical Pediatrics

摘　　要：目的探讨嗜酸性粒细胞性胃肠炎(EG)患儿外周血共刺激分子CD40和淋巴细胞亚群的动态变化及意义。方法应用流式细胞术(FCM)检测15例EG患儿(急性期和缓解期)和15例健康对照儿童的外周血CD 40表达及淋巴细胞亚群;酶联免疫吸附实验(ELISA法)检测血清白细胞介素(IL)-4水平;血细胞分析仪检测嗜酸性粒细胞(EOS)计数。结果急性期EG患儿外周血CD40、CD3^+、CD4^+、CD4^+/CD 8^+、CD19^+CD 23^+表达,血清IL-4水平和EOS计数均高于缓解期EG患儿和对照组,CD8^+低于缓解期EG患儿和对照组,差异均有统计学意义(P<0.05);缓解期EG患儿和对照组各指标比较差异均无统计学意义(P>0.05)。急性期EG患儿外周血CD40的表达与CD4^+,IL-4表达均呈正相关(P均<0.05)。结论 CD 40可能参与了EG的发病。CD 40介导CD 4^+T细胞分泌IL-4增多,导致EOS异常增多可能是EG的发病机制之一。ObjectiveTo explore the dynamic changes and signifcance of costimulatory molecules CD40 and lymphocyte subsets in peripheral blood of children with eosinophilic gastroenteritis （EG）. MethodsThe CD40 expression and lymphocyte subsets in peripheral blood were detected by fow cytometry （FCM） in 15 children with EG （acute stage and remission stage） and 15 healthy controls. The level of serum interleukin （IL） -4 was detected by enzyme-linked immunosorbent assay （ELISA）. The eosinophil （EOS） was count by blood cell analyzer. ResultsIn acute stage, the children with EG had signifcantly higher expression of CD40, CD3＋, CD4＋, CD4＋/CD8＋, and CD19＋CD23＋ in peripheral blood, higher serum IL-4 level, higher EOS count and lower CD8＋ than in remission stage and control group （P all〈0.05）. There were no differences between remission stage and control group （P〉0.05）. In acute stage, the expression of CD40 in peripheral blood in children with EG was positively correlated with the expression of CD4＋ and IL-4 （P all〈0.05）. ConclusionsCD40 may be involved in the pathogenesis of EG. That the increase of IL-4 secreted by CD4＋ T cells that were induced by CD40 results in abnormal increase of EOS may be one of mechanisms of the pathogenesis of EG.

关 键 词：淋巴细胞亚群 嗜酸性粒细胞性胃肠炎 流式细胞术 儿童 

分 类 号：R725.7[医药卫生—儿科]