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目的探讨变应性鼻炎(allergic rhinitis,AR)患者经体内螨变应原刺激后T-bet和CD19/CD23的变化。方法采取15例健康人和60例接受标准化螨变应原疫苗的体内特异性免疫治疗(SIT)达1年的AR患者外周血,用逆转录聚合酶链反应(RT-PCR)分析SIT前后1年外周血单核细胞(PBMC)中的T-bet mRNA表达变化情况。另外用流式细胞术(FCM)检测患者CD19/CD23水平SIT前后1年变化情况。结果 24例AR患者SIT前后PBMC中T-bet表达水平分别为(0.44±0.14)和(0.49±0.09),差异有统计学意义(t=2.324,P<0.05)。在对照组,该比值为(0.59±0.09),显著高于AR患者(P<0.01)。对照组和AR组CD19/CD23水平分别是(5.99±2.44)%和(13.53±5.41)%,P<0.05。42例单纯AR患者和合并有哮喘的18例AR患者的T-bet表达水平分别是(0.49±0.12)和(0.33±0.09),两组CD19/CD23水平分别是(12.32±5.71)%和(16.34±3.32)%,t值分别为5.411和3.407,P均<0.01;T-bet与CD23存在负相关(r=-0.260,P<0.05)。经SIT后,CD23水平显著下降(t=2.334,P<0.05)。经SIT后,T-bet mRNA表达显著上调(t=-2.324,P<0.05)。结论 T-bet在AR患者PBMC中的表达均下调;AR患者经SIT后,可以看到T-bet表达的上调和CD23水平的下降。T-bet对变应原体外反应低下,而对体内小剂量变应原刺激产生保护性的Th1型免疫反应。对变应性鼻炎SIT机理的新认识认为,转录因子水平是通过Th1优势来纠正Th1/Th2失衡,而这种方式是以Th1型特异性相关转录因子的上调表达介导的。
Objective To investigate the changes of T-bet and CD19 / CD23 in allergic rhinitis (AR) patients stimulated by mite allergens. Methods Peripheral blood of AR patients with 15 healthy individuals and 60 patients with SIT for 1 year receiving standardized mite allergen vaccine were collected and analyzed by reverse transcriptase polymerase chain reaction (RT-PCR) before and after 1 T-bet mRNA expression in peripheral blood mononuclear cells (PBMC) In addition, flow cytometry (FCM) was used to detect the change of CD19 / CD23 level 1 year before and after SIT. Results The expression of T-bet in PBMC of SIR patients before and after SIT was (0.44 ± 0.14) and (0.49 ± 0.09) respectively in 24 AR patients, the difference was statistically significant (t = 2.324, P <0.05). In the control group, the ratio was (0.59 ± 0.09), which was significantly higher than that in AR patients (P <0.01). The levels of CD19 / CD23 in control group and AR group were (5.99 ± 2.44)% and (13.53 ± 5.41)%, respectively, P <0.05. The T-bet expression levels in 52 patients with AR and 18 AR patients with asthma were The levels of CD19 / CD23 were (12.32 ± 5.71)% and (16.34 ± 3.32)% in the two groups, the values of t were 5.411 and 3.407, respectively, P <0.01; There was a negative correlation between bet and CD23 (r = -0.260, P <0.05). After SIT, CD23 level decreased significantly (t = 2.334, P <0.05). After SIT, T-bet mRNA expression was significantly up-regulated (t = -2.324, P <0.05). Conclusions The expression of T-bet in PBMC of patients with AR was down-regulated. The expression of T-bet and the decrease of CD23 level in AR patients after SIT were observed. T-bet response to allergens in vitro low, while the body of small doses of allergen-induced protective Th1-type immune response. New understanding of the SIT mechanism of allergic rhinitis argues that the level of transcription factors corrects Th1 / Th2 imbalance through Th1 predominance mediated by upregulated expression of Th1-specific transcription factors.