母乳喂养对婴儿CD4^(+)T淋巴细胞免疫反应的影响  

Effects of breastfeeding on immune response of CD4^(+)T lymphocytes in infants

作　　者：朱思敏 屠文娟[1] 张雯婷 屠子骐 汪骋安 ZHU Simin;TU Wenjuan;ZHANG Wenting;TU Ziqi;WANG Cheng'an(Center for Children's Health Promotion,Affiliated Changzhou Children's Hospital of Nantong University,Changzhou,Jiangsu 213000,China;Pediatric Centeral Laboratory,Affiliated Changzhou Children's Hospital of Nantong University;The First School of Clinical Medicine,SouthernMedical University;School of Stomatology,Nanjing Medical University)

机构地区：[1]南通大学附属常州儿童医院小儿健康促进中心,江苏常州213000 [2]南通大学附属常州儿童医院儿科中心实验室 [3]南方医科大学第一临床医学院 [4]南京医科大学口腔医学院

出　　处：《中国儿童保健杂志》2024年第1期103-107,共5页Chinese Journal of Child Health Care

基　　金：国家自然科学基金(81801493)。

摘　　要：目的探索母乳喂养对婴儿在非炎症状态下的CD4^(+)T淋巴细胞免疫反应的影响,并分析母乳整体成分的免疫调节意义,为提倡母乳喂养提供理论支持。方法本研究采用回顾性队列研究,按照入组标准选取2022年1—9月在南通大学附属常州儿童医院儿保科进行体检的6月龄婴儿为研究对象。根据喂养方式分为母乳喂养组(33例)和配方奶喂养组(27例)。采用流式细胞术检测外周血的CD4^(+)T淋巴细胞,包括辅助性T淋巴细胞(Th)1、Th2、Th17和调节性T淋巴细胞(Treg)的百分比,以及相关细胞因子白细胞介素(IL)-2、IL-4、IL-6、IL-10、肿瘤坏死因子(TNF)-α、干扰素(IFN)-γ、IL-17A的水平,比较上述指标在两组之间的差异。结果与配方奶喂养组比较,母乳喂养组婴儿外周血的Th1百分比(t=3.038)、Treg百分比(t=2.088)、Th1/Th2(Z=2.756)、IL-10(Z=2.297)及IFN-γ(Z=2.076)较高,Th17百分比(Z=2.704)、IL-17A(t=2.187)较低,差异均有统计学意义(P<0.05);两组间Th2百分比、IL-2、IL-4、IL-6、TNF-α水平差异无统计学意义(P>0.05)。结论母乳喂养对婴儿CD4^(+)T淋巴细胞免疫反应的调节作用表现为促进Th1/Th2向Th1方向发展以及Treg的免疫调节作用,但抑制Th17型免疫反应,这说明母乳整体成分有助于婴儿免疫系统发育成熟,增强免疫防御和免疫耐受。Objective To explore the effects of breastfeeding on the immune response of CD4^(+)T lymphocytes in infants in non-inflammatory state,and to analyze the immunomodulatory significance of the whole composition of breast milk.Methods A retrospective cohort study was conducted.From January to September 2022,six-month-old infants who took physical examination in the Child Healthcare Department of Changzhou Children's Hospital Affiliated to Nantong University,were selected based on inclusion criteria,and were divided into breastfeeding group(n=33)and formula feeding group(n=27)based on their feeding patterns.Flow cytometry was used to detect the percentage of CD4^(+)T cells,including helper T cell(Th)1,Th2,Th17,regulatory T cell(Treg),and the levels of related cytokines interleukin(IL)-2,IL-4,IL-6,IL-10,tumor necrosis factor(TNF)-α,interferon(IFN)-γ,IL-17 in peripheral blood.The differences in these indicators between the two groups were compared.Results Compared with the formula feeding group,the breastfeeding group showed significantly higher percentages of Th1(t=3.038),Treg(t=2.088).The ratio of Th1 to Th2(Z=2.756),IL-10(Z=2.297)and IFN-γ(Z=2.076)in the peripheral blood of the breastfeeding group were also significantly higher.Conversely,the breastfeeding group had significantly lower percentage of Th17(Z=2.704)and IL-17A(t=2.187)(P<0.05).There was no significant difference the percentage of Th2,as well as in the levels of IL-2,IL-4,IL-6 and TNF-αbetween the two groups(P>0.05).Conclusions Breastfeeding has a regulatory effect on the immune response of infant CD4^(+)T lymphocytes.It promotes the development of Th1/Th2 towards Th1 and the immunomodulatory effect of Treg.Moreover,it inhibits the Th17 type immune response.These findings suggest that the complete composition of breast milk contributes to the development and maturation of infant immune system,enhancing immune defense and immune tolerance.

关 键 词：母乳喂养 获得性免疫 CD4^(+)T淋巴细胞 辅助性T淋巴细胞 调节性T淋巴细胞 

分 类 号：R174.4[医药卫生—妇幼卫生保健]