舌下特异性免疫治疗对过敏性哮喘患儿Th1-Th2细胞因子平衡调控.docVIP

舌下特异性免疫治疗对过敏性哮喘患儿Th1/Th2细胞因子平衡调控 　【摘要】 目的：探讨舌下特异性免疫治疗（SLIT）对过敏性哮喘患儿T淋巴细胞表达Th1/Th2细胞因子（IL-2、IL-4、IFN-γ）之间的平衡以及血清IgE水平调控的作用。方法：选择粉尘螨变应原皮试阳性的过敏性支气管哮喘患儿95例作为观察对象，根据随机化原则分为两组，使用SLIT（粉尘螨滴剂）48例（治疗组），未使用SLIT 47例（对照组），在研究前、后分别取血，测定Th1、Th2细胞因子IFN-γ、IL-2、IL-4的表达及血清IgE水平。结果：SLIT疗程（1年）结束后，治疗组Th1细胞因子IFN-γ、IL-2表达分别增加了30.76%、33.23%，而Th2细胞因子IL-4表达及血清IgE的水平分别降低了31.07%、33.60%；与对照组相比各种细胞因子表达的差异均有统计学意义。结论：舌下特异性免疫治疗对于过敏性支气管哮喘，可显著纠正Th1/Th2表达细胞因子功能的失衡，减轻患者的变态反应性炎症。 【关键词】 过敏性哮喘；粉尘螨滴剂；儿童；免疫治疗 ［Abstract］Objective:To investigate the effect of the SLIT in balance of Th1/Th2 cytokines and the level of the serum IgE in children with allergic asthma. Methods:68 children with allergic asthma who showed positive skin reaction to dermatophagoides allergen skin test were selected and randomly divided into a SLIT treatment group and a control group. The SLIT treatment group received specific immunotherapy, and the blood of the two groups were gathered and the expression level of the IFN-γ,IL-2,IL-4 in the Th1/Th2 were measured before and after treatment,as well as the level of the serum IgE.Results:The expression levels of IFN-γ,IL-2 in the SLIT treatment group were increased by 30.76% and 33.23%,but the levels of IL-4,the serum IgE were decreased by 31.07% and 33.60%. And compared with the control group,there were significant differences after treatment in the treatment group.Conclusions:The functions of Th1 and Th2 cell of cytokines expression may be rebalanced after the treatment with the SLIT in the patients with allergic asthma caused by dust mites. ［Key words］Allergic asthma; Dermatophagoides farinae drops; Children; Immunotherapy 支气管哮喘是儿童最常见的变态反应性疾病，是一种与T细胞独特型细胞因子激活有关的免疫系统紊乱，研究发现，Th1/Th2细胞失衡与哮喘密切相关。特异性免疫治疗（SIT）是Ⅰ型变态反应性疾病（过敏性支气管哮喘）治疗的有效途径。临床上特异性免疫治疗可显著改善支气管哮喘患者的气道高反应性及肺功能，减轻哮喘症状及减少哮喘用药［1］。本研究以粉尘螨变应原皮试阳性的过敏性哮喘患儿为研究对象，旨在探讨舌下特异性免疫治疗对哮喘患者外周血Th1/Th2细胞表达的影响。 1 资料与方法 1.1 临床资料 选择我院2005年2月至2006年7月哮喘门诊依据1998年全国儿科呼吸病会议修订标准与分度［2］确诊为轻、中度稳定期的哮喘病儿95例，依据随机化原则（随机数表）分为两组。治疗组48例，其中男25例，女23例，年龄（8.0±2.6）岁；对照组4