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目的:从免疫学角度探讨哮喘患儿花剥苔形成的机制。方法:采用免疫组化方法检测舌苔脱落上皮细胞中角蛋白13及bcl-2蛋白的含量。应用流式细胞术检测外周血CD4+及细胞趋化因子受体3(cellchemokine receptor-3,CCR-3)的表达量。采用放射免疫法检测血清中皮质醇的含量。结果:哮喘花剥苔组患儿外周血CD4+和CCR-3水平明显高于哮喘非花剥苔组及正常组(P<0.05);哮喘花剥苔组、非哮喘花剥苔组血清中皮质醇含量低于其余各组(P<0.05)。哮喘花剥苔、非花剥苔组血清IgE水平明显高于其余各组(P<0.05)。哮喘花剥苔组、非哮喘花剥苔组舌苔上皮脱落细胞中角蛋白13的含量明显低于哮喘非花剥苔组、非哮喘非花剥苔组和正常对照组(P<0.05)。哮喘花剥苔组患儿舌苔上皮脱落细胞中bcl-2蛋白含量与其余各组比较无统计学差异。结论:花剥苔的形成与免疫反应密切相关,血清皮质醇水平降低、CD4+及CCR-3增多,可能促进了花剥苔的形成。同时,舌上皮细胞角化障碍及舌上皮细胞凋亡亦可能促进花剥苔的形成。
Objective: To investigate the mechanism of flower stripping moss formation in children with asthma from immunological point of view. Methods: Immunohistochemistry was used to detect the content of keratin 13 and bcl-2 protein in epithelial cells of the tongue off. Flow cytometry was used to detect the expression of CD4 (superscript +) and chemokine receptor 3 (CCR-3) in peripheral blood. Radioimmunoassay was used to detect serum cortisol levels. Results: The levels of CD4 + and CCR-3 in the peripheral blood of children with asthma and flower-peeling group were significantly higher than those of the non-flower-peeling group and the normal group (P <0.05) Alcohol content was lower than the other groups (P <0.05). The levels of serum IgE in asthmatic flowers and non-stripping moss group were significantly higher than those in other groups (P <0.05). The content of keratin 13 in the exfoliated cells of the tongue coating of asthmatic flower peeling group and non-asthmatic flower peeling group was significantly lower than that of the non-flower peeling group, non-asthmatic non-flower peeling group and the normal control group (P <0.05). There was no significant difference in the expression of bcl-2 protein in the epithelial exfoliated cells of the tongue coating in asthma exfoliating group compared with the other groups. CONCLUSION: The formation of flower stripping moss is closely related to the immune response. The serum cortisol level is decreased, and the increase of CD4 + and CCR-3 may promote the formation of flower stripping moss. Concurrently, keratinization of tongue epithelial cells and apoptosis of tongue epithelial cells may also contribute to the formation of flower-peeling moss.