布地奈德对变应性鼻炎患者外周血树突状细胞免疫功能的影响  

Effects of budesonide aerosol inhalation on the immunological functions of peripheral dendritic cells in patients with allergic rhinitis

作　　者：申震[1] 李白芽[1] 戴浩 张少强[1] 白艳霞[1] 邵渊[1] SHEN Zhen;LI Baiya;DAI Hao;ZHANG Shaoqiang;BAI Yanxia;SHAO Yuan(Department of Otolaryngology Head and Neck Surgery,the First Affiliated Hospital of Xi＇an Jiaotong University,Xi＇an,710061,China)

机构地区：[1]西安交通大学第一附属医院耳鼻咽喉头颈外科,西安710061

出　　处：《临床耳鼻咽喉头颈外科杂志》2018年第18期1391-1395,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨布地奈德鼻喷雾剂治疗变应性鼻炎(AR)过程中患者外周血树突状细胞(DC)免疫功能的变化。方法:选取中重度持续性AR患者25例,给予布地奈德鼻喷雾剂治疗8周,评估患者治疗前、治疗4周和8周时患者AR相关症状和指标、外周血DC数量、比例以及活化程度的变化。结果:AR患者治疗4周和8周后症状评分、嗜酸粒细胞比例以及血清AR特异性抗体sIgE和T-IgE均下降,差异有统计学意义,治疗结束时总有效率达到88%。患者DC细胞数目和DC/PBMC较治疗前降低,差异有统计学意义(P<0.05)。与治疗前相比,AR患者治疗4周和8周后,活化DC细胞表面标志分子CD86和CD80均不同程度降低,而糖皮质激素诱导的亮氨酸拉链蛋白逐渐升高,均差异有统计学意义(P<0.05)。与治疗前相比,DC细胞分泌的IL-10的浓度随着治疗时间延长而降低,同时DC刺激T细胞分泌的IFN-γ水平在治疗后显著升高,均差异有统计学意义(P<0.05)。结论:布地奈德有助于抑制AR患者外周血DC的活化和成熟,这可能与其纠正DC参与的Th2反应从而减轻患者症状有关。Objective：To investigate the immunologic functional changes of peripheral dendritic cells（DC）in patients with allergic rhinitis（AR）during the treatment by budesonide aerosol inhalation.Method：25 patients with moderate to severe persistent AR were concluded in current study,and they were given budesonide aerosol inhalation for 8 weeks.AR related nasal symptom scores and indices,peripheral DC counts and percentages as well as their activation before and 4 weeks,8 weeks after treatment were determined.Result：There were significant decrease in nasal symptom scores,eosinophils,AR specific IgE antibodies after 4 and 8 weeks of treatment.The overall clinical efficiency reached 88% at the end of the treatment.Peripheral DC counts and DC/PBMC decreased in comparison with the levels of pre-treatment（P〈0.05）.Compared with the levels before treatment,DC activation markers CD86 and CD80 reduced to various extent,while glucocorticoid-induced leucine zipper（GILZ）positive cells gradually elevated（P〈0.05）.In the DC secreted IL-10 decreased against the treatment duration,while IFN-γfrom DC conditioned T cells statistically increased after treatment（P〈0.05）.Conclusion：Budesonide suppressed DC activation and maturation,which might redirect DC-involved Th2 response,in turn alleviating the AR symptoms.

关 键 词：布地奈德气雾剂 鼻炎 变应性 树突状细胞 免疫功能 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]