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目的:比较过敏性哮喘患者、无症状的过敏者和不过敏的健康人外周血CD4+CD25+调节性T细胞(Treg)数量的差异及对特异性过敏原刺激的反应。方法:选取急性发作期的尘螨过敏性哮喘患者20例,无症状的尘螨过敏者24例,不过敏的健康人22例,分离外周血单个核细胞(PBMC)并进行CFSE染色,分别在不刺激和1mg/L尘螨抗原(rDer p 1)刺激情况下体外培养7d,流式细胞仪检测CD4+CD25+Treg的比率和分裂指数;ELISA法检测各组细胞培养上清液和血清中白细胞介素-4(IL-4)和干扰素-γ(IFN-γ)的水平。结果:过敏性哮喘患者CD4+CD25+Treg比率和IFN-γ基础水平均低于无症状的尘螨过敏者和不过敏的健康人,且过敏原刺激后增加不明显;但IL-4的基础水平最高,过敏原刺激后差异更显著。无论刺激与否,无症状的尘螨过敏者CD4+CD25+Treg比率均与不过敏的健康人的水平接近。但过敏原刺激后无症状的尘螨过敏者CD4+CD25+Treg比率高于过敏性哮喘患者,且存在高水平的IFN-γ反应。结论:接触过敏原后,过敏性哮喘患者和无症状的过敏者表现出不同的免疫反应模式。过敏性哮喘患者抗原特异性CD4+CD25+Treg反应不足,存在过高Th2反应。无症状过敏的发生可能与机体对特异性过敏原刺激产生高水平的CD4+CD25+Treg反应及高水平的IFN-γ反应有关。
Objective: To compare the difference of the number of CD4 + CD25 + regulatory T cells (Tregs) and the response to specific allergen in peripheral blood of patients with allergic asthma, asymptomatic and non-allergic subjects. Methods: 20 cases of dust mite allergic asthma, 24 cases of asymptomatic dust mite allergy and 22 cases of non-allergic healthy individuals were selected during acute attack. Peripheral blood mononuclear cells (PBMCs) were isolated and stained with CFSE Stimulated with 1 mg / L dust mite antigen (rDer p 1) for 7 days, the ratio of CD4 + CD25 + Treg and the index of division were detected by flow cytometry; Interleukin-4 (IL-4) and Interferon-γ (IFN-γ) levels. Results: The basal levels of CD4 + CD25 + Treg and IFN-γ in patients with allergic asthma were lower than those in asymptomatic subjects with allergic to dust mite and allergic to healthy subjects, and the allergen had no obvious increase after stimulation; however, the basis of IL-4 The highest level, the difference is more significant after allergen stimulation. Regardless of whether stimulated or not, asymptomatic dust mite allergy with CD4 + CD25 + Treg ratio are not sensitive and healthy people close to the level. However, asymptomatic allergen-induced dust mite allergy CD4 + CD25 + Treg ratio higher than allergic asthma patients, and there is a high level of IFN-γ response. Conclusions: Allergic asthma patients and asymptomatic allergies exhibit different patterns of immune response after exposure to allergens. Allergic asthma patients with antigen-specific CD4 + CD25 + Treg response, there is excessive Th2 response. The occurrence of asymptomatic allergy may be related to the body’s stimulation of specific allergens to produce high levels of CD4 + CD25 + Treg response and high levels of IFN-γ response.