重组人干扰素α1b通过调控Foxp3对儿童传染性单核细胞增多症免疫功能的影响  

Effect of recombinant human interferonα1b on immune function of children with infectious mononucleosis through regulation of Foxp3

作　　者：祁卫卫 杨宁[1] 路娟 夏红 韩艳珺[1] QI Wei-wei;YANG Ning;LU Juan;XIA Hong;HAN Yan-jun(Department of Pediatrics, Xingtai People’s Hospital, Xingtai 054000, China)

机构地区：[1]邢台市人民医院儿科,河北邢台054000

出　　处：《中国感染控制杂志》2022年第4期346-352,共7页Chinese Journal of Infection Control

基　　金：河北省医学科学研究重点课题计划(20180659);河北省邢台市科技局计划项目(2019ZC298)。

摘　　要：目的探讨重组人干扰素α1b(rhIFN-α1b)通过调控叉状头/翅膀状螺旋转录因子3(Foxp3)表达对传染性单核细胞增多症(IM)患儿机体免疫功能的调节作用。方法选取2019年3月—2020年3月某院儿科收治的98例IM患儿,使用简单随机数字表法将其随机分成干扰素组(n=49)和更昔洛韦组(n=49)。干扰素组采取注射用rhIFN-α1b雾化吸入治疗,更昔洛韦组予以注射用更昔洛韦静脉滴注治疗,疗程均为7 d。观察两组患儿的临床疗效及安全性,并比较治疗前后两组患儿外周血单个核细胞(PBMC)中Foxp3信使核糖核酸(Foxp3 mRNA)表达水平、机体免疫功能、血清相关细胞因子的水平。结果干扰素组总有效率和血清EB病毒脱氧核糖核酸(EBV-DNA)阴转率[87.8%(43/49)、89.8%(44/49)]均高于更昔洛韦组[71.4%(35/49)、73.5%(36/49),均P<0.05]。与更昔洛韦组相比,干扰素组患儿在热程、咽峡炎好转时间及异常实验室指标(白细胞计数、异型淋巴细胞比例、丙氨酸氨基转移酶和肌酸激酶同工酶)复常时间和住院时间均缩短(均P<0.05)。两组患儿治疗后外周血CD3^(+)、CD8^(+)水平和血清肿瘤坏死因子-α、白介素(IL)-6水平较本组治疗前均下降(均P<0.05),外周血CD4^(+)水平、CD4^(+)/CD8^(+)比值及PBMC中Foxp3 mRNA表达水平和血清免疫球蛋白(Ig)IA、IgG、IL-2浓度均高于本组治疗前(均P<0.05);但干扰素组患儿改善均更明显(均P<0.05)。干扰素组不良反应率低于对照组(4.1%VS 20.4%,P<0.05)。结论rhIFN-α1b可能通过上调IM患儿PBMC中Foxp3 mRNA的表达水平,以纠正患儿异常的细胞免疫功能,提高其体液免疫水平。Objective To evaluate the regulatory effect of recombinant human interferonα1b(rhIFN-α1b)on immune function of children with infectious mononucleosis(IM)through regulating the expression of Foxp3.Methods 98 children with IM treated in the department of pediatrics of a hospital from March 2019 to March 2020 were randomly divided into interferon group(n=49)and ganciclovir group(n=49)by simple randomized number table method.Interferon group received rhIFN-α1b atomization inhalation treatment,ganciclovir group received ganciclovir intravenous drip,treatment courses were both 7 days.Clinical efficacy and safety of two groups of children were observed,expression level of Foxp3 mRNA in peripheral blood mononuclear cells(PBMC),immune function and serum-related cytokines of two groups of children before and after treatment were compared.Results The total effective rate and negative conversion rate of serum EB virus DNA(EBV-DNA)in interferon group were both higher than those in ganciclovir group(87.8%[43/49]vs 71.4%[35/49],89.8%[44/49]vs 73.5%[36/49];both P<0.05).Compared with ganciclovir group,children in interferon group had shorter time of heat course and pharyngitis,shorter recovery time of abnormal laboratory indexes(leukocyte count,proportion of hetero-lymphocytes,ala-nine aminotransferase[ALT],creatine kinase isoenzyme MB[CK-MB]),and shorter hospitalization time(all P<0.05).The Levels of peripheral blood CD3^(+)and CD8^(+),as well as serum tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)in both groups of patients after treatment decreased compared with those before treatment(all P<0.05),the values of CD4^(+)and CD4^(+)/CD8^(+)in peripheral blood,expression level of Foxp3 mRNA in PBMC,as well as concentrations of serum immunoglobulin A(IgA),IgG and interleukin-2(IL-2)in both groups were all hi-gher than those before treatment(all P<0.05);however,the improvement was more obvious in interferon group(all P<0.05).The adverse reaction rate of interferon group was lower than that of control group(4.1%vs 20.4%,P<0

关 键 词：传染性单核细胞增多症 儿童 重组人干扰素Α1B 叉状头/翅膀状螺旋转录因子3 细胞免疫 体液免疫 

分 类 号：R725.1[医药卫生—儿科]