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目的:观察哮喘急性发作期患儿外周血Th17水平和功能状态,初步探讨Th17在儿童哮喘发病中的作用。方法:以正常儿童(对照组,n=20)为对照,流式细胞术(FCM)检测哮喘急性发作期患儿(哮喘组,n=26)外周血Th17以及Th1,Th2细胞百分率,ELISA方法检测外周血单个核细胞(PBMC)体外培养上清IL-17,IFN-γ以及血浆IL-17,IL-23,IgE水平。结果:(1)哮喘组和对照组外周血CD4+T中CD4+IL-17+T比例[(1.25±0.66)%vs(1.27±0.66)%(P>0.05)];CD4+IL-4+T比例[(2.40±2.55)%vs(2.52±1.26)%(P>0.05)];两组比较无统计学意义。哮喘组CD4+IFN-γ+T比例低于对照组[15.79±7.48vs24.10±12.70(P<0.05)]。(2)PHA活化的PBMC体外培养72h上清中,哮喘组IL-17水平为17.53(0~245.57)ng/L,低于对照组101.74(25.12~500.60)ng/L(P<0.01);IFN-γ水平与对照组比较无统计学意义[3507±2788ng/Lvs3027±2737ng/L];两组血浆中IL-17均<2ng/L,IL-23均<15ng/L。(3)哮喘组血浆总IgE499.26(2.3~945.1)IU/mL,高于对照组54.57(1.7~318.26)IU/mL(P<0.001);IgE阳性(>150IU/mL)和阴性(<150IU/mL)哮喘患儿体外PBMC培养上清中IL-17,IFN-γ水平比较无统计学意义。结论:哮喘急性发作期患儿外周血Th1细胞以及PHA活化的IL-17表达水平降低,Th1水平和Th17功能异常的机制及其在儿童哮喘发病中的作用值得进一步研究。
OBJECTIVE: To observe the level of Th17 in children with acute exacerbation of asthma and its functional status, and to explore the role of Th17 in the pathogenesis of childhood asthma. Methods: The levels of Th17, Th1 and Th2 cells in peripheral blood of children with asthma (n = 26) were detected by flow cytometry (FCM) in normal children (n = 20) The levels of IL-17, IFN-γ and plasma IL-17, IL-23 and IgE in peripheral blood mononuclear cells (PBMCs) were detected. Results: (1) The proportion of CD4 + IL-17 + T in CD4 + T in peripheral blood of asthma group and control group was (1.25 ± 0.66)% vs (1.27 ± 0.66)% + T ratio [(2.40 ± 2.55)% vs (2.52 ± 1.26)% (P> 0.05)]. There was no significant difference between the two groups. The proportion of CD4 + IFN-γ + T in asthma group was lower than that in control group [15.79 ± 7.48 vs 24.10 ± 12.70 (P <0.05)]. (2) The level of IL-17 in the asthmatic group was 17.53 (0 ~ 245.57) ng / L in the supernatant of PHA-activated PBMC cultured in vitro for 72h, which was lower than that of the control group (101.74; 25.12 ~ 500.60) ng / L; The level of IFN-γ was not significantly different from that of the control group [3507 ± 2788 ng / L vs 3027 ± 2737 ng / L]. IL-17 in both plasma was lower than 2ng / L and IL-23 was less than 15ng / L in both groups. (3) The total plasma IgE499.26 (2.3-945.1) IU / mL in asthma group was 54.57 (1.7-318.26) IU / mL higher than the control group (P <0.001); IgE positive (> 150IU / mL) and negative 150IU / mL) in children with asthma in vitro PBMC culture supernatant of IL-17, IFN-γ levels were not statistically significant. Conclusion: The expression of Th1 and PHA-activated IL-17 in peripheral blood of children with acute exacerbation of asthma is decreased. The mechanism of Th1 and Th17 dysfunction and their role in the pathogenesis of childhood asthma deserve further study.