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目的探讨脐血瘦素(leptin)质量浓度与新生儿免疫功能的关系及其可能的免疫调控机制。方法2003年3~10月河北医科大学第四医院儿科对正常分娩的早产儿30例、足月儿60例,分别采用放射免疫分析(RIA)、免疫透射比浊法及流式细胞术(FCM)检测脐血leptin、粒细胞-巨噬细胞集落刺激因子(GM-CSF)、IgG、IgA、IgM、补体(C3、C4)、白细胞介素-4(IL-4)、γ-干扰素(IFN-γ)质量浓度及bcl-2蛋白表达量、T淋巴细胞亚群、淋巴细胞凋亡率。结果脐血leptin质量浓度与IgG(r=0·630,P<0·01)、C3(r=0·340,P<0·01)、C4(r=0·253,P<0·05)、CD4+T淋巴细胞百分率(r=0·295,P<0·05)、CD8+T淋巴细胞百分率(r=0·377,P<0·01)及IFN-γ质量浓度(r=0·323,P<0·05)、GM-CSF质量浓度(r=0·236,P<0·05)、bcl-2蛋白表达量(r=0·318,P<0·05)均呈正相关,与IL-4质量浓度(r=-0·277,P<0·05)、淋巴细胞凋亡率(r=-0·532,P<0·01)呈负相关,而与IgA、IgM无显著相关(均P>0·05)。结论脐血leptin质量浓度与新生儿免疫功能密切相关,leptin具有增强新生儿细胞免疫功能的作用,而对体液免疫功能影响较小。leptin可上调bcl-2蛋白表达和GM-CSF质量浓度,抑制淋巴细胞的凋亡,此作用可能是leptin免疫调节作用的重要机制。
Objective To investigate the relationship between cord blood leptin concentration and neonatal immune function and its possible mechanism of immune regulation. Methods From March to October 2003, 30 preterm infants and 60 full-term infants undergoing normal labor were enrolled in pediatric department of Fourth Hospital of Hebei Medical University from March to October 2003. Radioimmunoassay (RIA), immunoturbidimetry and flow cytometry (FCM) ) Were tested for leptin, GM-CSF, IgG, IgA, IgM, complement (C3, C4), interleukin-4 (IL- IFN-γ) concentration and bcl-2 protein expression, T lymphocyte subsets, lymphocyte apoptosis rate. Results The leptin levels in umbilical cord blood were significantly lower than those in controls (r = 0.630, P <0.01), C3 (r = 0.343, P <0.01) , The percentage of CD4 + T lymphocytes (r = 0.295, P <0.05), the percentage of CD8 + T lymphocytes (r = 0.377, P <0.01) and IFN- 0 · 323, P <0 · 05), GM-CSF concentration (r = 0.236, P <0.05) and bcl-2 protein (R = -0.277, P <0.05), the rate of lymphocyte apoptosis (r = -0.532, P <0.01) was negatively correlated with the concentration of IL-4 , IgM had no significant correlation (all P> 0.05). Conclusion The concentration of leptin in cord blood is closely related to the immune function of neonates. Leptin can enhance the cellular immune function of neonates, but has little effect on humoral immune function. Leptin can upregulate the expression of bcl-2 protein and the concentration of GM-CSF and inhibit the apoptosis of lymphocytes, which may be an important mechanism of leptin immunoregulation.