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目的比较皮下免疫治疗何舌下免疫治疗对哮喘患儿免疫应答功能影响的差异。方法收集尘螨致敏哮喘患儿86例,分为舌下免疫治疗组(SLIT组,n=29)、皮下免疫治疗组(SCIT组,n=13)、结束皮下免疫治疗足疗程组(结束SCIT组,n=14)以及常规药物治疗组(对照组,n=30)。体外水平检测各组患儿外周血单个核细胞经螨蛋白浸液刺激后CD4+T淋巴细胞中调节性T淋巴细胞比例(Treg%)的变化;比较SCIT组和SLIT组患儿治疗前、治疗后6个月、治疗后12个月体液免疫学指标和临床疗效指标变化的差异。结果未给予抗原刺激时,SCIT组患儿CD4+T细胞中Treg%显著高于SLIT组、对照组;给予抗原刺激后的4组CD4+T细胞中Treg%均显著性降低。在免疫治疗后6个月和12个月,SCIT组患儿其血清s Ig E和s Ig G4水平与治疗前相比差异均有统计学意义,而SLIT组患儿仅血清s Ig E水平与治疗前相比差异有统计学意义,s Ig G4水平未见随时间变化而变化。结论不同免疫治疗途径在引发哮喘患儿内在免疫学应答反应上存在时间差异性,其中SCIT免疫治疗患儿免疫应答反应出现的时间更早。
Objective To compare the effects of sublingual immunotherapy sublingual immunotherapy on immune response in children with asthma. Methods Totally 86 children with allergic asthma were collected and divided into sublingual immunotherapy group (SLIT group, n = 29), subcutaneous immunotherapy group (SCIT group, n = 13), and subcutaneous immunotherapy SCIT group, n = 14) and the conventional drug treatment group (control group, n = 30). The levels of regulatory T lymphocyte (Treg%) in CD4 + T lymphocytes stimulated by mite infusion in peripheral blood mononuclear cells (PBMCs) of children with SCIT and SLIT were compared before and after treatment 6 months after treatment, 12 months after the humoral immunological indicators and clinical efficacy indicators of the difference. Results Treg% of CD4 + T cells in SCIT group was significantly higher than that in SLIT group and control group when antigen-stimulation was not given; Treg% of CD4 + T cells in group SCIT was significantly decreased. At 6 months and 12 months after immunotherapy, the serum levels of s Ig E and s Ig G4 in children with SCIT were significantly different from those before treatment, while the levels of serum s Ig E, The difference was statistically significant before treatment, s Ig G4 level did not change with time. Conclusions There are time-varying immunological responses to different immunotherapy pathways in children with asthma, of which immunization response to SCIT immunotherapy occurs earlier.