手足口病患儿IL―18对Th1Th2平衡细胞因子IL―1IL―8IL―4IL―10水平变化影响.docVIP

手足口病患儿IL―18对Th1Th2平衡细胞因子IL―1IL―8IL―4IL―10水平变化影响 　　【摘要】 目的 观察手足口病（HFMD）患儿IL-18与Th1型细胞因子IL-1、IL-8及Th2型细胞因子IL-4、IL-10的水平变化，并探讨手足口病发病的分子机制。 　　方法 选取2011年10月～2014年3月收治住院并诊断为HFMD患儿46例作为病例组，其中普通病例40例（普通病例组），重症病例6例（重症病例组）， 选取同期经过健康体检中心体检的健康幼儿40例作为对照组，采用形态观察、ELISA法检测各细胞因子水平、淋巴细胞凝胶电泳观察手段进行研究。 　　结果 与对照组比较，病例组表皮层增厚，血管增生、扩张，伴有炎症细胞浸润、表皮细胞碎片。与对照组比较，普通病例组和重症病例组的IL-18、IL-1、IL-8、IL-4、IL-10水平均显著升高（P0.01）。通过淋巴细胞凝胶电泳观察到，病例组彗星细胞比对照组多。 　　结论 IL-18可能通过影响Th1型、Th2型细胞因子水平对Th1/Th2平衡进行调控而参与手足口病发病机制，IL-18有可能作为临床干预手足口病的潜在靶点。 　　【关键词】 白细胞介素18；手足口病；细胞因子 　　【Abstract】 Objective To observe the changes of levels of IL-18，Th1 cytokines （IL-1 and IL-8） and Th2 cytokines（IL-4 and IL-10） of children with hand-foot-mouth disease（HFMD），and to investigate the molecular mechanism of HFMD. 　　Methods 46 children who were admitted to hospital and diagnosed with HFMD were collected as case group，among which 40 normal cases were selected as normal case group，and 6 severe cases were selected as severe case group.And 40 healthy children proved by physical examination in physical examination center in the same period were selected as control group.Then，morphologic changes of skin lesion was observed，levels of cytokines was tested by ELISA，damage of lymphocyte was observed by gel electrophoresis. 　　Results Compared with the control group，epidermis of the cases group thickened，blood vessels proliferated and expanded，associating with inflammatory cell infiltration and epidermal cells fragments.Levels of IL-18， IL-1， IL-8，IL-4 and IL-10 of both normal case group and severe case group significantly increased comparing with those of the control group（P0.01）.Observation of lymphocytes gel electrophoresis showed that the case group had more comet cells than the control group. 　　Conclusion IL-18 might regulate Th1/Th2 balance by affecting the levels of cytokine of type Th1 and Th2，which might be the part of the molecular mechanism of HFMD，and IL-18 is expected to become the potential molecule in the targeted therapy of