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目的 观察基因重组γ 型干扰素 (IFN γ)对呼吸道合胞病毒 (RSV)毛细支气管炎 (毛支 )患儿TH1/TH2亚群功能的调节作用。方法 将 4 0例RSV毛支患儿随机分为IFN γ观察组 2 0例及对照组 2 0例。选择 15例健康婴儿为正常组。治疗前用单克隆抗体双色免疫荧光FITC/PE行双标记 ,流式细胞仪检测患儿外周血单个核细胞 (PBMCs)辅助性T淋巴细胞CD4 + 及其TH1亚群CD4 + CD4 5RA+ ,TH2亚群CD4 + CD4 5RO+ 的表达 ,用ELISA方法检测患儿血清中细胞因子IFN γ、IL 4水平。经IFN γ治疗后 7～ 10d复查。结果 与正常组相比 ,RSV毛支患儿外周血辅助性T淋巴细胞CD4 + ,TH1亚群CD4 + CD4 5RA+ 明显下降 (P <0 0 5 ) ,TH2亚群CD4 +CD4 5RO+ 没有明显变化 (P >0 0 5 ) ,TH1/TH2比值明显降低 (P <0 0 5 ) ,血清中IFN γ、IL 4水平均有降低 ,其中IFN γ水平下降非常明显 (P <0 0 1) ,IFN γ/IL 4比值降低 (P <0 0 5 )。经IFN γ治疗后 ,观察组IFN γ水平明显升高 ,TH1/TH2、IFN γ/IL 4比值升高 ,观察组及对照组IL 4水平均没有明显变化。结论 婴幼儿RSV毛支患儿存在TH 细胞及其免疫功能状态紊乱 ,主要表现为TH1及其功能下降 ;TH2及其功能相对增强 ,TH1/TH2的失衡是导致婴幼儿下呼吸道感染发生TH2样反应的重要免疫机制。
Objective To investigate the regulatory effect of IFNγ on the function of TH1 / TH2 subsets in children with respiratory syncytial virus (RSV) bronchiolitis (bronchiolitis). Methods 40 children with RSV bronchiolitis were randomly divided into 20 cases of IFN γ observation group and 20 cases of control group. Fifteen healthy infants were selected as normal group. Before treatment, double-labeled immunofluorescence FITC / PE double labeled with monoclonal antibody was used to detect CD4 + CD4 + CD4 + 5RA + and TH2 in TH1 subpopulations of peripheral blood mononuclear cells (PBMCs) The expression of CD4 + CD4 + 5RO + was detected by ELISA. The levels of cytokines IFN-γ and IL-4 in children were detected by ELISA. After IFN γ treatment 7 ~ 10d review. Results Compared with the normal group, CD4 + CD4 + 5RA + T helper lymphocytes in peripheral blood of children with RSV bronchiolitis significantly decreased (P <0.05), and TH2 subgroup CD4 + CD4 + 5RO + did not change significantly (P <0.05). The levels of IFN-γ and IL-4 in serum were decreased, the level of IFN-γ was significantly decreased (P <0.01), the level of IFN-γ / IL 4 ratio decreased (P <0 0 5). After IFN γ treatment, the levels of IFN γ in the observation group were significantly increased, and the ratios of TH1 / TH2 and IFN γ / IL 4 were increased. There was no significant change in the levels of IL 4 in the observation group and the control group. Conclusions Infants with RSV bronchiolitis have disorder of TH cells and immune function, which is mainly manifested as the decrease of TH1 and its function; the increase of TH2 and its function; the imbalance of TH1 / TH2 leads to TH2-like reaction in infants with lower respiratory tract infection The important immune mechanism.