摘要
目的探讨丙种球蛋白输注对川崎病患儿外周血CD4^+CD25^+调节T细胞(Treg)与淋巴细胞亚群分布的影响及临床意义。方法流式细胞术检测40例川崎病患儿和30例体检健康儿童外周血中CD4^+CD25^+Treg细胞的表达水平以及108例川崎病患儿和41例体检健康儿童外周血中淋巴细胞亚群分布。ELISA法检测川崎病患儿血浆中TGF-β1浓度。108例川崎病患儿中有30例收集到对应的丙种球蛋白(IVIG)治疗后全血,流式细胞术检测CD4^+CD25^+Treg、TGF-β1及淋巴细胞亚群在川崎病患儿丙种球蛋白(IVIG)治疗前后表达水平的差异。结果与健康体检组相比,川崎病患儿CD4^+CD25^+Treg细胞及血浆TGF-β1的表达水平明显降低,外周血CD3+、CD8^+T细胞及NK细胞的表达水平明显降低,CD4^+T细胞、B细胞及CD4^+/CD8^+水平明显增高,差异均有统计学意义(均P<0.01)。与IVIG治疗前相比,川崎病患儿IVIG治疗后外周血CD4^+CD25^+Treg细胞及血浆TGF-β1的表达水平明显增高(均P<0.05),外周血CD3+、CD8^+T细胞及NK细胞的表达水平明显增高(均P<0.05),CD4^+T细胞、B细胞及CD4^+/CD8^+水平明显降低(均P<0.05)。治疗后患儿外周血CD4^+CD25^+Treg水平、血浆TGF-β1浓度及淋巴细胞亚群表达水平与健康对照相比无差异(P>0.05)。结论 Treg细胞与淋巴细胞比例失常是导致儿童川崎病免疫紊乱的重要原因。检测CD4^+CD25^+调节T细胞及淋巴细胞亚群分布对评估川崎病患儿的细胞免疫状况,辅助诊断和指导治疗具有重要的临床价值。
This study was performed to investigate the changes of CD4＋CD25＋ regulatory T cells（Tregs） andlymphocyte subsets in children with Kawasaki disease（KD） undergoing intravenous immunoglobulin（IVIG）treatment. The percentages of CD4＋CD25＋ Tregs in 40 children with KD and 30 healthy controls were detected usingflow cytometry, as did the levels of lymphocyte subsets in 108 children with KD and 41 healthy controls. Plasmalevel of TGF-β1 in each patient was detected by enzyme-linked immunosorbent assay（ELISA）. Data showed thatthe percentages of CD4＋CD25＋Treg cells and TGF-β1 in KD were significantly lower than those in healthyvolunteers, as did the levels of CD3＋, CD8＋T and NK cells. However, the levels of CD4＋T, B cells and the ratio ofCD4＋/CD8＋were significantly higher in KD children compared with healthy volunteers（both P〈0.01）. Comparedwith prior treatment of IVIG, the levels of CD4＋CD25＋Treg cells, TGF-β1, CD3＋, CD8＋T and NK cells wereobviously increased after treatment（both P〈0.05）, while the levels of CD4＋T, B cells and the ratio of CD4＋/CD8＋were significantly decreased（both P〈0.05）. Moreover,the percentages of post treatment CD4＋CD25＋Tregcells, TGF-β1 and lymphocyte subsets in KD children were similar to those observed in healthy controls. Our study suggests that the percentages of CD4＋CD25＋Treg cellsand lymphocyte subsets could be key factors in monitoring the immune dysfunction of KD children. And the CD4＋CD25＋regulatory T cells and lymphocyte subsets in peripheral blood of KD children is significant to evaluate thecellular immune function of KD children, and helpful to the clinical diagnosis and therapy.
作者
郑丽君
张淑平
吴梦
ZHENG Lijun ZHANG Shuping WU Meng(Department of Laboratory Medicine, Traditional Chinese Medical Hospital of Li Shui District in Nanjing, Nanjing 211200, China Department of Laboratory Medicine, Children＇s Hospital Affiliated to Nanjing Medical University, 210029 Nanjing, China)
出处
《免疫学杂志》
CAS
CSCD
北大核心
2017年第11期991-995,共5页
Immunological Journal
