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目的探讨血吸虫粪检虫卵阳性者抗体检测为阴性(以下简称“抗体低应答者”)的免疫机制。方法对鄱阳湖血吸虫病流行区142例粪检血吸虫卵阳性病例采用虫卵抗原与成虫抗原包被ELISA检测Ig G抗体,并利用ROC曲线确定抗体高、低应答组;检测、比较两组细胞免疫水平及细胞因子水平。结果共筛查出8名抗体低应答者。高、低应答组各同型抗体水平相比,除SWAP-Ig A(t=-1.588,P>0.1)外,差异均有统计学意义(t=-14.517~-2.866,P均<0.05)。与抗体高应答组相比,抗体低应答组外周血CD3~+T细胞占比略升高,CD4+T与CD8+T细胞占比、CD4+/CD8+比值及CD4+CD25+Treg细胞占比均降低,但差异均无统计学意义(t=-1.72~0.974,P均>0.05)。在SEA或SWAP刺激下,两组人群PBMC分泌的IFN-γ水平和IL-10水平差异亦无统计学意义(t=-2.426~0.216,P>0.05)。结论抗体低应答组与高应答组人群仅见同型抗体水平差异;低感染度者在血吸虫释放抗原物质、形成抗原-抗体复合物后,血液循环中抗体滴度非常低,从而导致难以检出是抗体低应答的原因之一。
Objective To investigate the immune mechanism of schistosomiasis fecal egg-positive antibody test negative (hereinafter referred to as “antibody low responders ”). Methods 142 cases of schistosomiasis serology in schistosomiasis in Poyang Lake were enrolled in this study. Eggs antigen and adult antigen were used to detect Ig G antibody by ELISA, and the high and low antibody response groups were determined by ROC curve. The cellular immunity Levels and cytokine levels. Results A total of 8 low-responders were screened. There was significant difference between SWAP-Ig A (t = -1.588, P> 0.1), t = -14.517 ~ -2.866 (all P <0.05). The proportion of CD4 + T and CD8 + T cells, the ratio of CD4 + / CD8 +, and the proportion of CD4 + CD25 + Treg cells in peripheral blood of patients with low antibody response were slightly higher than those of patients with high antibody response Decreased, but the difference was not statistically significant (t = -1.72 ~ 0.974, P> 0.05). The levels of IFN-γ and IL-10 secreted by PBMC in both groups were also not significantly different between SEA and SWAP stimulation (t = -2.426-0.216, P> 0.05). CONCLUSIONS: There is only a difference in the level of the homotype antibody between low-responders and high responders. In the low-infectivity patients, antigens are released in the schistosomes and the antibody titers in the blood circulation are very low after antigen-antibody complexes are formed. As a result, it is difficult to detect antibodies One of the reasons for low response.