2型固有淋巴细胞及其相关因子在支气管肺发育不良中的变化及意义

Changes and significance of type 2 innate lymphoid cells and their related factors in bronchopulmonary dysplasia

摘要:

目的 探讨支气管肺发育不良（bronchopulmonary dysplasia，BPD）早产儿外周血2型固有淋巴细胞（group 2 innate lymphoid cell，ILC2）及白细胞介素（interleukin，IL）-33、IL-25、胸腺基质淋巴生成素（thymic stromal lymphopoietin，TSLP）、IL-5、IL-13的变化及意义。方法 选择2020年9月—2021年12月江苏大学附属医院儿科收治的胎龄<32周且住院时间≥14 d的76例早产儿为研究对象，根据BPD诊断标准分为BPD组（n=30）和非BPD组（n=46），比较两组早产儿生后1 d、7 d及14 d外周血ILC2占淋巴细胞百分率，以及IL-33、IL-25、TSLP、IL-5、IL-13水平差异及意义。结果 BPD组早产儿出生体重及胎龄低于非BPD组（P<0.05）。生后7 d和14 d，BPD组ILC2、IL-33、TSLP及IL-5水平均高于非BPD组（P<0.05），其预测BPD发生的曲线下面积均>0.7（P<0.05）。多因素logistic回归分析显示，校正胎龄和出生体重后，生后7 d和14 d外周血IL-33、TSLP及IL-5与BPD发生密切相关（P<0.05）。结论 BPD早产儿生后早期固有免疫活化伴随相关因子表达上调，其中ILC2、IL-33、TSLP及IL-5是具有早期诊断价值的生物学指标。

Abstract:

Objective To investigate the changes and significance of type 2 innate lymphoid cells (ILC2), interleukin-33 (IL-33), interleukin-25 (IL-25), thymic stromal lymphopoietin (TSLP), interleukin-5 (IL-5), and interleukin-13 (IL-13) in peripheral blood of preterm infants with bronchopulmonary dysplasia (BPD).Methods A total of 76 preterm infants with a gestational age of <32 weeks and a length of hospital stay of ≥14 days who were admitted to the Department of Pediatrics of the Affiliated Hospital of Jiangsu University from September 2020 to December 2021 were enrolled. According to the diagnostic criteria for BPD, they were divided into a BPD group with 30 infants and a non-BPD group with 46 infants. The two groups were compared in terms of the percentage of ILC2 and the levels of IL-33, IL-25, TSLP, IL-5, and IL-13 in peripheral blood on days 1, 7, and 14 after birth.Results The BPD group had significantly lower birth weight and gestational age than the non-BPD group (P<0.05). On days 7 and 14 after birth, the BPD group had significantly higher levels of ILC2, IL-33, TSLP, and IL-5 than the non-BPD group (P<0.05), and these indices had an area under the curve of >0.7 in predicting the devolpment of BPD (P<0.05). Multivariate logistic regression analysis showed that after adjusting for gestational age and birth weight, peripheral blood IL-33, TSLP and IL-5 on days 7 and 14 after birth were closely related to the devolpment of BPD (P<0.05).Conclusions Early innate immune activation and upregulated expression of related factors may be observed in preterm infants with BPD. ILC2, IL-33, TSLP, and IL-5 may be used as biological indicators for early diagnosis of BPD.