川崎病患儿治疗前后抗体分泌细胞和免疫球蛋白样受体水平的变化  

Changes of Antibody-Secreting Cells and Leukocyte Immunoglobulin-Like Receptor Levels in Children with Kawasaki Disease before and after Treatment

作　　者：秦彦 文一州 刘青[1] 左文旻 Qin Yan;Wen Yizhou;Liu Qing;Zuo Wenmin(Women’s and Children’s Hospital Affiliated to University of Electronic Science and Technology of China,Chengdu Women’s and Children’s Central Hospital,Chengdu 611731,China)

机构地区：[1]电子科技大学附属妇女儿童医院·成都市妇女儿童中心医院,成都611731

出　　处：《儿科药学杂志》2023年第9期33-37,共5页Journal of Pediatric Pharmacy

摘　　要：目的:探讨川崎病(KD)患儿B细胞亚群特异性抗体分泌细胞(ASC)、免疫球蛋白样受体(LILR)表达特征。方法:选取我院2018年1月至2021年3月收治的急性期KD患儿32例为观察组及体检健康儿童19例为对照组。其中11例KD患儿(类固醇组)Egami评分>3分,预测可能存在静脉注射免疫球蛋白(IVIG)无反应,采用类固醇药物治疗,其余21例患儿(IVIG组)均给予IVIG治疗,比较对照组与观察组治疗前后CD19^(+)B细胞群中ASC、白细胞LILR表达情况。结果:观察组KD患儿外周血单核细胞(PBMC)水平、B细胞亚群中ASC水平高于对照组(P<0.05)。IVIG组及类固醇组患儿治疗后PBMC水平、PBMC中CD4^(+) T细胞、CD8^(+)T细胞水平均高于治疗前(P<0.05),ASC水平低于治疗前(P<0.05),且类固醇组ASC占比低于IVIG组(P<0.05)。流式细胞术检查显示,4种抑制性LILR亚型在单核细胞上表达,LILRB1在每个B细胞亚群上表达,而LILRB2或LILRB3在B细胞亚群上的表达在急性期和治疗后均较少;LILRB4在ASC上呈现唯一表达,其急性期水平低于单核细胞;观察组ASC的LILRB1、LILRB4水平高于对照组,且治疗后低于治疗前(P<0.05)。结论:KD患儿急性期ASC呈升高趋势且富含LILRB4表达,治疗结果不受类固醇给药影响。ASC可能在KD发生发展过程中发挥着重要作用。Objective:To probe into the expression characteristics of B cell subset specific antibody-secreting cells(ASC)and leukocyte immunoglobulin-like receptors(LILR)in children with Kawasaki disease(KD).Methods:Thirty-two children with acute KD admitted into our hospital from Jan.2018 to Mar.2021 were extracted as the observation group and 19 healthy children were selected as the control group.Egami score of 11 KD children(steroid group)was greater than 3 points,predicting that intravenous immunoglobulin(IVIG)was not responsive,and steroid drugs were administered.The remaining 21 children(IVIG group)received IVIG treatment.Expression of ASC and LILR in CD19^(+)B cells was compared before and after treatment between the control group and observation group.Results:In the observation group,peripheral blood mononuclear cell(PBMC)and ASC in B cell subsets of children with KD were higher than those in the control group(P<0.05).In the IVIG group and steroid group,PBMC levels,CD4^(+)T cells and CD8^(+)T cells in PBMC after treatment were higher than those before treatment(P<0.05),while ASC levels were lower than those before treatment(P<0.05),and ASC in the steroid group was lower than that in the IVIG group(P<0.05).Flow cytometry analysis showed that all four inhibitory LILR subtypes were expressed on monocytes,LILRB1 was expressed on each B cell subset,while the expression of LILRB2 or LILRB3 on B cell subsets was lower during the acute phase and after treatment.LILRB4 was uniquely expressed on ASC,and its level during the acute phase was lower than that on monocytes.The levels of LILRB1 and LILRB4 on ASC in the observation group were higher than those in the control group and decreased after treatment(P<0.05).Conclusion:In the acute stage,ASC of children with KD shows an elevated trend and is enriched in LILRB4 expression,the treatment outcome is not affected by steroid administration.ASC cells may play an important role in the occurrence and progression of KD.

关 键 词：川崎病 特异性抗体分泌细胞 免疫球蛋白样受体 B细胞 

分 类 号：R725.4[医药卫生—儿科]