儿童哮喘患者外周血Th17,Th2细胞及不同来源样本相关细胞因子表达与气道炎症诱导痰细胞学分类的相关性研究  

Study on the Correlation between the Expression of Th17,Th2 Cells and Cytokines in Peripheral Blood and the Cytological Classification of Airway Inflammation-induced Sputum in Children with Asthma

作　　者：陈芬 许春华 姚彤 安美玉 罗新辉 CHEN Fen;XU Chun-hua;YAO Tong;AN Mei-yu;LUO Xin-hui(Department of Medicine,Children’s Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China)

机构地区：[1]新疆维吾尔自治区儿童医院儿内科,乌鲁木齐830001

出　　处：《现代检验医学杂志》2021年第3期62-67,共6页Journal of Modern Laboratory Medicine

基　　金：新疆维吾尔自治区卫生健康青年医学科技人才专项项目(编号:WJWY-202007)。

摘　　要：目的探讨不同类型哮喘儿童外周血Th2,Th17细胞及不同来源样本相关细胞因子表达与气道炎症诱导痰细胞学分类的相关性。方法选取2018年4月~2020年8月新疆维吾尔自治区儿童医院接诊的急性发作期哮喘患儿55例行诱导痰中性粒细胞百分比(NEU%)和嗜酸性粒细胞百分比(EOS%)计数;根据其结果分为中性粒细胞哮喘组(NA组,n=24)和嗜酸性粒细胞哮喘组(EA组,n=31);另选取同期健康儿童50例作为对照组(HC组)。采用流式细胞仪检测外周血Th17,Th2细胞及Th17细胞中STAT5和BCL-2表达;ELISA法检测外周血单核细胞(PBMC)培养液和支气管肺泡灌洗液(BALF)中IL-17和IL-10表达;qRT-PCR法检测外周血单核细胞RORγt表达;采用Pearson行相关性分析。结果NA组NEU%高于EA组和HC组,EA组高于HC组(F=342.918,P<0.001);EA组EOS%高于NA组和HC组,NA组高于HC组(F=118.931,P<0.001),差异均有统计学意义。NA组Th17%及IL-17水平高于EA组和HC组,EA组高于HC组(F=47.569~256.602,均P<0.001);EA组Th2%及IL-10水平高于NA组和HC组,NA组高于HC组(F=16.636~169.271,均P<0.001),差异均有统计学意义。哮喘患儿诱导痰NEU%与Th17%,IL-17水平呈明显正相关(r=0.695~0.803,均P<0.05);EOS%与Th2%,IL-10水平呈明显正相关(r=0.684~0.759,均P<0.05)。NA组RORγt表达及BCL-2,STAT5阳性率高于EA组和HC组,EA组高于HC组,差异均有统计学意义(F=53.390~283.618,均P<0.001)。结论中性粒细胞哮喘患儿与嗜酸性粒细胞哮喘患儿气道炎症分别表现为诱导痰NEU%,EOS%明显增高,并分别与不同来源样本的Th17%,IL-17水平及Th2%和IL-10水平呈正相关,可将Th2/Th17作为不同类型哮喘患儿诊断、治疗及预后的标志物。中性粒细胞性哮喘气道炎症与Th17细胞分化增强及已分化的Th17细胞存活延长密切相关。Objective To investigate the correlation between the expression of Th2,Th17 cells and related cytokines from different samples in peripheral blood of children with different types of asthma and the cytological classification of airway inflammation-induced sputum.Methods The percentages of neutrophils(NEU%)and eosinophils(EOS%)in induced sputum were selected from 55 children with acute attack asthma admitted to Children’s Hospital of Xinjiang Uygur Autonomous Region from April 2018 to August 2020.According to the results,they were divided into neutrophilic asthma group(NA group,n=24)and eosinophilic asthma group(EA group,n=31).Another 50 healthy children in the same period were selected as control group(HC group).The expressions of STAT5 and BCL-2 in Th17 and Th2 cells and Th17 cells in peripheral blood were detected by flow cytometry.The expression of IL-17 and IL-10 in the culture medium of peripheral blood mononuclear cells(PBMC)and bronchoalveolar lavage fluid(BALF)were detected by ELISA.The expression of RORγt in peripheral blood monocytes was detected by qRT-PCR.Pearson line correlation analysis was used.Results NEU%in NA group was higher than that in EA group and HC group,and EA group was higher than HC group(F=342.918,P<0.001).EOS%in EA group was higher than that in NA group and HC group,and NA group was higher than HC group(F=118.931,P<0.001),respectively,the differences was statistically singnificant.The levels of Th17% and IL-17 in NA group were higher than those in EA and HC group,and those in EA group were higher than those in HC group(F=47.569~256.602,all P<0.001).The levels of Th2% and IL-10 in EA group were higher than those in NA group and HC group,and those in NA group were higher than those in HC group(F=16.636~169.271,all P<0.001),repectively,the differences were statistically significant.NEU% was positively correlated with Th17% and IL-17 levels in asthmatic children(r=0.695~0.803,all P<0.05).EOS% was positively correlated with Th2% and IL-10 levels(r=0.684~0.759,all P<0.05).The expression,

关 键 词：儿童 哮喘 辅助性T细胞2 辅助性T细胞17 气道炎症 

分 类 号：R725.6[医药卫生—儿科] R392.11[医药卫生—临床医学]