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目的对尘螨过敏的哮喘儿童外周全血体外持续给予尘螨主要过敏原Der p和Der f刺激,观察辅助性T淋巴细胞(Th)内细胞因子的表达,探讨过敏原暴露对Th1/Th2偏移的影响。方法选择尘螨皮试阳性的哮喘患者23例,采集全血,体外与尘螨主要过敏原Der p、Der f共同孵育培养8h,以单克隆抗体对T淋巴细胞表面抗原、细胞内白介素(IL)-4,干扰素(IFN)-γ进行标记,应用流式细胞技术检测Th细胞内细胞因子的表达。结果哮喘患者全血体外Der p、Der f持续暴露后(过敏原暴露组),Th0、Th1、Th2表达率分别为(0.83±0.45)%、(10.70±4.42)%、(2.16±1.17)%,非过敏原暴露组Th0、Th1、Th2表达率分别为(0.93±0.52)%、(9.19±3.75)%、(1.67±0.82)%。过敏原暴露组Th2表达率显著高于非过敏原暴露组(P<0.05),而两组Th0、Th1表达率的差异无显著性(P>0.05)。过敏原暴露组因Th2增高,Th1/Th2比例降低,Th1/Th2平衡向Th2偏移,与非过敏原暴露组的差异有显著性(P<0.01)。结论Der p、Der f对Th细胞有明显的选择性,过敏原的持续暴露促进Th2优势表达,Th1/Th2平衡向Th2转化,可能是引起哮喘症状反复和加重的机制之一。因此,过敏原的回避和特异性的脱敏治疗也是哮喘治疗的措施之一,应予以必要的重视。
Objective To investigate the effects of allergen exposure on Th1 / Th2 cytokine expression in peripheral blood of asthmatic children with dust mite allergy and to observe the expression of cytokines in helper T lymphocytes (Th) Effect of migration. Methods Twenty-three asthmatic patients with dust mite skin test were selected. Whole blood was collected and incubated with Der p and Der f, the major allergens of dust mite in vitro for 8 h. Monoclonal antibodies against T lymphocyte surface antigen, interleukin (IL) ) -4, interferon (IFN) -γ, and detect the expression of cytokines in Th cells by flow cytometry. Results The expressions of Th0, Th1 and Th2 in the whole blood of patients with asthma were (0.83 ± 0.45)%, (10.70 ± 4.42)% and (2.16 ± 1.17)% (0.93 ± 0.52)%, (9.19 ± 3.75)%, (1.67 ± 0.82)% respectively in non-allergen exposure group. The expression of Th2 in allergic exposure group was significantly higher than that in non-allergen exposed group (P <0.05), while the expression of Th0 and Th1 in two groups had no significant difference (P> 0.05). Allergen exposure group due to Th2 increased, Th1 / Th2 ratio decreased Th1 / Th2 balance to Th2 offset, and non-allergen exposure group differences were significant (P <0.01). Conclusion Der p and Der f are obviously selective to Th cells. The sustained exposure of allergen promotes the expression of Th2 and the balance of Th1 / Th2 to Th2, which may be one of the mechanisms leading to the recurrence and aggravation of asthma symptoms. Therefore, the avoidance of allergens and specific desensitization therapy is also one of the measures of asthma treatment, which should be given the necessary attention.