基于JAK/STAT信号通路探究重组人干扰素α-2b联合乙酰半胱氨酸治疗毛细支气管炎患儿喘息反复发作效果及机制  

Effect of Recombinant Human Interferonα-2b Combined with Acetylcysteine on Recurrent Wheezing in Children with Capillary Bronchitis Based on JAK/STAT Signaling Pathway and Its Mechanism

作　　者：王鹏[1] 田姜美子 WANG Peng;TIAN Jiangmeizi(Department of Pediatric Medicine,Dingzhou People's Hospital,Dingzhou,Hebei 073000,China;Department of Pediatric Medicine,Shijiazhuang Children's Hospital,Shijiazhuang 050000,China)

机构地区：[1]定州市人民医院小儿内科,河北定州073000 [2]石家庄市儿童医院小儿内科,石家庄050000

出　　处：《临床误诊误治》2023年第3期95-99,共5页Clinical Misdiagnosis & Mistherapy

基　　金：河北省卫生健康委员会项目(2018324)。

摘　　要：目的 基于Janus激酶(JAK)/信号转导与转录活性因子(STAT)信号通路探究重组人干扰素α-2b联合乙酰半胱氨酸治疗毛细支气管炎患儿喘息反复发作效果及机制。方法 选取2020年3月—2022年2月收治的毛细支气管炎患儿156例,依据治疗方案不同分为观察组和对照组2组各78例。观察组予重组人干扰素α-2b联合乙酰半胱氨酸治疗,对照组予乙酰半胱氨酸治疗。比较2组治疗7 d后临床效果及症状和体征消失时间、住院时间,治疗前及治疗7 d后JAK/STAT信号通路关键蛋白[干扰素调节因子9(IRF9)、信号转导与转录活性因子1(STAT1)和信号转导与转录活性因子2(STAT2)]表达及相关细胞因子[白细胞介素-6(IL-6)、基质金属蛋白酶-9(MMP-9)和组织型金属蛋白酶抑制物-1(TIMP-1)]、辅助性T细胞17(Th17)、调节性T细胞(Treg)水平,以及治疗期间不良反应发生率、治疗后6个月喘息复发率。结果 治疗7 d后,观察组总有效率、IRF9、STAT1、STAT2表达和Treg水平高于对照组;IL-6、MMP-9、TIMP-1和Th17水平低于对照组(P<0.01)。观察组咳嗽、喘憋、喘息、湿啰音消失时间及住院时间均短于对照组(P<0.01)。治疗期间,2组不良反应总发生率比较差异无统计学意义(P>0.05)。治疗后6个月,观察组喘息复发率低于对照组(P<0.01)。结论 重组人干扰素α-2b联合乙酰半胱氨酸治疗毛细支气管炎患儿喘息反复发作效果显著,可促进症状、体征消失,加速康复进程,降低喘息反复发作风险;机制可能为其抑制IL-6释放,激活JAK/STAT信号通路,促使Th17向Treg转化,增强机体免疫应答,且调控MMP-9、TIMP-1表达,减轻支气管及肺损伤。Objective To explore the effect of recombinant human interferon α-2b combined with Acetylcysteine in the treatment of recurrent wheezing and its mechanism in children with bronchiolitis based on the Janus kinase(JAK)/Signal transduction and Transcriptional activity factor(STAT)signaling pathway.Methods A total of 156 children with bronchiolitis treated from March 2020 to February 2022 were selected and divided into observation group(n=78)and control group(n=78)according to different treatment regimens.The observation group was treated with Recombinant Human Interferon α-2b combined with Acetylcysteine,and the control group was treated with Acetylcysteine.The clinical effect,disappearance time of symptoms and signs and length of hospital stay were compared between the two groups at 7 d after treatment.Before and at 7 d after treatment,JAK/STAT signaling pathway key proteins[interferon regulatory factor 9(IRF9),signal transduction and transcriptional activity factor 1(STAT1)and signal transduction and transcriptional activity factor 2(STAT2)]and related cytokines[interleukin-6(IL-6),matrix metalloproteinase-9(MMP-9)and tissue inhibitor of metalloproteinase 1(TIMP-1)],helper T cell 17(Th17),and regulatory T cell(Treg)levels,as well as the incidence of adverse reactions during treatment and wheezing recurrence at 6 months after treatment were compared between the two groups.Results At 7 d after treatment,the total effective rate,IRF9,STAT1,STAT2 expression and Treg level in the observation group were higher than those in the control group,while the levels of IL-6,MMP-9,TIMP-1 and Th17 were lower than those of control group(P<0.01).The disappearance time of cough,wheezing,wheezing,wet rales and length of hospital stay in the observation group were shorter than those in the control group(P<0.01).During treatment,there was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).At 6 months after treatment,the recurrence rate of wheezing in the observation group was lower th

关 键 词：毛细支气管炎 喘息 重组人干扰素Α-2B 乙酰半胱氨酸 干扰素调节因子9 信号转导与转录活性因子1 白细胞介素-6 基质金属蛋白酶-9 辅助性T细胞17 调节性T细胞 

分 类 号：R725.6[医药卫生—儿科]