基因重组γ-型干扰素治疗小儿毛细支气管炎对T淋巴细胞调节作用的观察  

Observation of the effect of IFN-γ used for treating infants with RSV bronchiolitis on the regulation of T-lymphocytes

作　　者：张艳敏[1] 罗树舫[1] 雷春莲[1] 阎辉[1] 成革胜[1] 

机构地区：[1]西安交通大学第一医院儿科,710061

出　　处：《中国实用儿科杂志》2002年第10期611-613,共3页Chinese Journal of Practical Pediatrics

基　　金：陕西省卫生厅基金资助批准号 :970 62

摘　　要：目的　观察基因重组γ 型干扰素 (IFN γ)对呼吸道合胞病毒 (RSV)毛细支气管炎 (毛支 )患儿TH1/TH2亚群功能的调节作用。方法　将 4 0例RSV毛支患儿随机分为IFN γ观察组 2 0例及对照组 2 0例。选择 15例健康婴儿为正常组。治疗前用单克隆抗体双色免疫荧光FITC/PE行双标记 ,流式细胞仪检测患儿外周血单个核细胞 (PBMCs)辅助性T淋巴细胞CD4 + 及其TH1亚群CD4 + CD4 5RA+ ,TH2亚群CD4 + CD4 5RO+ 的表达 ,用ELISA方法检测患儿血清中细胞因子IFN γ、IL 4水平。经IFN γ治疗后 7～ 10d复查。结果　与正常组相比 ,RSV毛支患儿外周血辅助性T淋巴细胞CD4 + ,TH1亚群CD4 + CD4 5RA+ 明显下降 (P <0 0 5 ) ,TH2亚群CD4 +CD4 5RO+ 没有明显变化 (P >0 0 5 ) ,TH1/TH2比值明显降低 (P <0 0 5 ) ,血清中IFN γ、IL 4水平均有降低 ,其中IFN γ水平下降非常明显 (P <0 0 1) ,IFN γ/IL 4比值降低 (P <0 0 5 )。经IFN γ治疗后 ,观察组IFN γ水平明显升高 ,TH1/TH2、IFN γ/IL 4比值升高 ,观察组及对照组IL 4水平均没有明显变化。结论　婴幼儿RSV毛支患儿存在TH 细胞及其免疫功能状态紊乱 ,主要表现为TH1及其功能下降 ;TH2及其功能相对增强 ,TH1/TH2的失衡是导致婴幼儿下呼吸道感染发生TH2样反应的重要免疫机制。Objective Evaluate the effect of recombined IFN γ on the functions of T H1/T H2 in RSV infection.Methods Forty patients with RSV lower respiratory tract infections were divided randomly into 2 groups (each 20 patients),and 15 normal healthy infants were chosen as controls.Before treatment,the expression of CD4 +CD45RA +,CD4 +CD45RO + in PBMCs were measured by flow cytometry analysis,measure IFN γ,IL 4 level in serum before and after IFN γ treatment using ELISA method,and compare with control group.Results In RSV(+) infant's CD4 + cells decreased greatly,and CD4 +CD45RA +,CD4 +CD45RO + all decreased,but CD4 +CD45RO + was not obvious compared with control,P>0 05.T H1/T H2 ratio decreased in RSV infants.IFN γand IL 4 both decreased greatly.But IFN γ level decreased greater than IL 4 level.IFN γ/IL 4 ratio decreased in RSV(+) group.After IFN γ treatment,IFN γ level increased greatly.T H1/T H2 and IFN γ/IL 4 ratios increased.IL 4 level had no obvious change.Conclusion In the PBMCs of RSV infants,there is disorder of immunology.which mainly are the decrease of T H1 and its function and the relative increase of T H2 and its function.The imbalance of T H1/T H2 is an important immunological mechanism of T H2 type reaction.After IFN γ treatment,the ratio of T H1/T H2 and IFN γ/IL 4 increases,the imbalance of T H1/T H2 is corrected,but IL 4 level has no obvious change.

关 键 词：呼吸道合胞病毒 辅助性T细胞亚群 干扰素 治疗 小儿 毛细支气管炎 

分 类 号：R725.622.1[医药卫生—儿科]