灭活卡介苗经皮接种治疗婴幼儿哮喘对IgE ECP IFN-γ IL-4水平的影响

Effects of inactivated bacillus Calmette-Guerin inoculation on IgE ,ECP, IFN-γ and IL-4 levels in infants with asthma

摘要:

目的 为进一步探讨灭活卡介苗治疗婴幼儿哮喘的免疫学作用机制 ,应用灭活卡介苗经皮接种 ,观察患儿机体IgE、嗜酸性细胞阳离子蛋白 (ECP)、IFN γ、IL 4的水平变化及改变程度。方法 将哮喘患儿随机分为常规治疗组 (常规组 )与灭活卡介苗治疗组 (卡介苗组 ) ,进行 6个月的治疗后 ,观察患儿在治疗前后的IgE ,ECP ,IL 4 ,IFN γ的变化 ,另设 2 0例正常儿童作为对照组。结果 ①治疗前卡介苗组和常规组IgE ,ECP与IL 4均高于对照组 ,IFN γ低于对照组 ,差异有显著性 (P <0 .0 5 ) ;卡介苗组与常规组比较差异无显著性 (P >0 .0 5 ) ;②卡介苗组治疗后ECP与IL 4低于治疗前 ,IFN γ较治疗前有升高 ,其差异均有显著性 (P <0 .0 5 ) ,IL 4和IFN γ呈明显负相关 ,且IFN γ与IL 4的变化各自均有明显的线性关系。IgE在治疗前后无显著性差异 (P >0 .0 5 )。常规组治疗前后IgE ,ECP与IL 4水平差异无显著性 ,但IFN γ水平治疗后增加 ,差异有显著性 (P <0 .0 1)。结论 灭活卡介苗治疗能刺激婴幼儿哮喘患儿IFN γ生成增多 ,下调IL 4水平 ,可能与干预治疗能诱导TH1细胞的优势分化 ,调节TH1 TH2平衡有关 ;同时 ,能降低ECP水平 ,减轻气道慢性炎症反应 ;但短期内对IgE水平未发现有显著影响。

Abstract:

Objective To study the changes of IFN-γ, IL-4, ECP and IgE levels in children with asthma before and after inactivated bacillus Calmette-Guerin (BCG) inoculation. Methods Forty-five young children with asthma aging from 9 months to 3 years were involved in this study. Serum levels of IgE and ECP were determined with enzyme linked fluoroimmunoassay by Phamacia CAP system. The concentrations of IFN-γ and IL-4 from peripheral blood mononuclear cells (PBMC) were measured using ELISA before and after inactivated BCG inoculation. Forty infants with asthma who received the routine treatment and twenty healthy infants served as the controls. Results After inactivated BCG inoculation for 6 months, the IFN-γ level increased significantly from 16.4± 7.1 pg/L to 241.6± 111.3 pg/L (P< 0.01). The IL-4 and ECP levels decreased significantly from 214.4± 90.9 pg/L and 13.4± 20.2 μg/L to 46.1± 21.5 pg/L and 5.5± 6.5 μg/L respectively (P< 0.05). The IL-4 level was significantly negatively correlated with the IFN-γ level (r= 0.626, P< 0.05). There was no difference in the serum IgE level before and after BCG treatment. In patients who received the routine treatment, only IFN-γ levels differed from that of before treatment ( 32.0± 12.1 pg/L vs 17.6± 7.2 pg/L; P< 0.01). Conclusions Inactivated BCG treatment may increase IFN-γ levels and decrease IL-4 levels, which is favorable to the regulation of T-cell balance. It also can decrease the ECP level and relieve chronic airway inflammation response, but it fails to respond to IgE level.