过敏原特异性免疫对过敏性鼻炎患者血清IgE、IgG4和趋化因子水平的影响  

Effect of specific allergen immunotherapy on serum IgE,IgG4 and MCP-1 levels in patients with allergic rhinitis

作　　者：张艳[1] 储俊才 王慧[1] 李勇[2] Zhang Yan;Chu Juncai;Wang Hui;Li Yong(Department of Otorhinolaryngology,The Fourth People＇s Hospital of Taizhou City,Jiangsu Province,225300 China;Department of Otolaryngology,Taizhou City People＇s Hospital,Taizhou,Jiangsu 225309,China)

机构地区：[1]江苏省泰州市第四人民医院耳鼻咽喉科,泰州225300 [2]江苏省泰州市人民医院耳鼻咽喉科,泰州225309

出　　处：《广西医科大学学报》2018年第11期1526-1530,共5页Journal of Guangxi Medical University

摘　　要：目的:研究过敏原特异性免疫治疗(SIT)对过敏性鼻炎(AR)患者血清中IgE、IgG4和趋化因子水平的影响。方法:选取2013年1月至2014年12月于江苏省泰州市第四人民医院就诊的120例AR患者,其中69名患者接受SIT为SIT组,另外51名患者进行常规治疗为对照组,对所有患者随访3年。在治疗前和治疗后4周、7周、10周、27周,以及治疗后1年、2年、3年收集所有患者的血液标本,检测两组患者血清中IgE、IgG4和趋化因子[白细胞介素(IL)-8、干扰素诱导蛋白10(IP-10)、人巨噬细胞炎性蛋白1(MIP-1)α、MIP-1β、调节激活正常T-细胞表达分泌因子(RANTES)、嗜酸细胞活化趋化因子(Eotaxin)、单核细胞趋化蛋白1(MCP-1)]水平。结果:随访结束时,SIT组治疗总有效率为88.4%,显著高于对照组的49.0%(P<0.05);两组治疗后血清IgE、IgG4、MCP-1和Eotaxin浓度变化有明显区别,SIT组患者血清中的MCP-1、Eotaxin浓度在治疗后7周、27周均高于对照组(均P<0.05);在治疗后10周时SIT组治疗后血清中的IgE浓度明显高于治疗前和对照组(均P<0.05),而对照组患者血清中的IgE浓度则显著低于治疗前和SIT组(均P<0.05);治疗后7周开始,SIT组血清中IgG4浓度逐渐升高,直到试验终点,一直保持上升趋势,而对照组患者血清中IgG4浓度一直没有明显变化。结论:SIT能有效治疗AR,可能与IgG4介导的免疫机制发挥的有益作用有关。Objective： To investigate the effects of allergen-specific immunotherapy （SIT） on serum IgE, IgG4 and MCP-1 levels in patients with allergic rhinitis （AR）.Methods： A total of 120 AR patients from January 2013 to December 2014 in our hospital were selected, and assigned to received SIT （ n =69, SIT group） or conventional treatment （ n =51, control group）. All patients were followed up for 3 years. Blood samples were collected before SIT and 4, 7, 10 and 27 weeks and 1, 2 and 3 years after therapy. Serum IgE, IgG4, IL-8, IP-10, MIP-1α, MIP-1β, RANTES, Eotaxin and MCP-1 levels were assessed.Results： The response rate in the SIT group was 88.4%, which was significantly higher than that in the control group （49.0%） （ P 〈0.05）. The levels of IgE, IgG4, Eotaxin and MCP-1 in serum were obviously different between groups. The Eotaxin and MCP-1 levels at 7 and 27 weeks post-treatment in the SIT group were significantly higher than those in the control group. The IgE level in SIT group was higher than that in the control group at week 10 post-treatment and before treatment （ P 〈0.05）. However, the IgE level was markedly decreased in the control group after treatment （ P 〈0.05）. The serum IgG4 level in the SIT group was gradually elevated from week 7 to the end of this study, while it did not change in the control group.Conclusion： SIT was effective for AR possibly related to the IgG4 mediated immunodepression.

关 键 词：过敏原特异性免疫治疗 过敏性鼻炎 IGE IGG4 MCP-1 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]