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目的探讨肺炎支原体肺炎(MPP)患儿NK细胞亚型的变化及其与特应质之间的关系。方法收集2010年7月-2011年2月于本院住院或门诊就诊的MPP患儿33例,其中MPP伴特应质患儿18例,MPP不伴特应质组15例。同时收集非MPP(NMPP)患儿20例,其中NMPP伴特应质患儿9例,NMPP不伴特应质患儿11例。另收集15例健康儿童作为健康对照组。收集所有研究对象外周静脉血标本,采用密度梯度离心法分离获得外周血单个核细胞,分别用标准刺激剂[佛波酯(PMA)+离子霉素(Ion)]孵育4 h,或特异性肺炎支原体(MP)抗原孵育24 h,或不予刺激剂孵育,应用流式细胞术测定NK细胞内细胞因子IL-4和IFN-γ水平。结果 1.PMA+Ion刺激后,MPP组、NMPP组和健康对照组NK细胞内IL-4、IFN-γ表达的差异均无统计学意义(Pa>0.05)。2.在MP抗原不同水平刺激下(0.1μg.L-1,0.2μg.L-1),MPP组NK细胞内IL-4、IFN-γ水平高于NMPP组及健康对照组(Pa<0.05),NMPP组与健康对照组无统计学差异(Pa>0.05)。MPP伴特应质组IL-4水平高于MPP不伴有特应质组(Pa<0.05),而IFN-γ表达水平在2组间则无明显差异(Pa>0.05);IL-4和IFN-γ表达水平在NMPP伴特应质组和NMPP不伴特应质组患儿之间均无明显差异(Pa>0.05)。3.MPP组提高MP抗原刺激水平,IL-4表达水平的增幅随之上升,而IFN-γ表达水平的增幅则逐渐下降。结论在MPP患儿中,标准刺激剂不能改变NK细胞来源的IL-4、IFN-γ水平,用MP抗原刺激能明显提升NK细胞来源的IL-4及IFN-γ水平,且以IL-4升高为主。这一现象在MPP伴特应质的患儿中更为突出,且与MP抗原水平有关。MP感染促使NK细胞来源的IL-4水平明显升高,与特应质相互协同,从而加重过敏症状。
Objective To investigate the changes of NK cell subtypes in children with Mycoplasma pneumoniae pneumonia (MPP) and its relationship with atopy. Methods Totally 33 children with MPP admitted to our hospital from July 2010 to February 2011 were enrolled. Among them, 18 were MPP patients with MPP and 15 were not MPP. At the same time, 20 children with non-MPP (NMPP) were collected, including 9 children with NMPP and 11 children with NMPP who did not. Another 15 healthy children were collected as healthy control group. Peripheral venous blood samples were collected from all the subjects. Peripheral blood mononuclear cells were isolated by density gradient centrifugation and incubated for 4 h with standard stimulant [PMA + Ion] or specific pneumonia Mycoplasma (MP) antigen incubated for 24 h, or without stimulant, the determination of cytokines IL-4 and IFN-γ levels in NK cells by flow cytometry. Results 1. After stimulation with PMA + Ion, the expression of IL-4 and IFN-γin NK cells of MPP group, NMPP group and healthy control group showed no significant difference (P> 0.05). The levels of IL-4 and IFN-γ in NK cells in MPP group were significantly higher than those in NMPP group and healthy control group (P <0.05) at different levels of MP antigen (0.1μg.L-1 and 0.2μg.L-1) ), There was no significant difference between NMPP group and healthy control group (Pa> 0.05). The level of IL-4 in the MPP group was higher than that in the MPP group (P <0.05), while the level of IFN-γ was no significant difference between the two groups (P> 0.05) There was no significant difference in the level of IFN-γ between the NMPP group and the NMPP group (P> 0.05). MPP group increased the level of MP antigen stimulation, the increase of IL-4 expression level increased, while the increase of IFN-γincreased. CONCLUSION: The standard stimulant can not change the level of IL-4 and IFN-γ in NK cells. In MP MP, the level of IL-4 and IFN-γ in NK cells can be obviously increased by stimulating with MP antigen. Mainly increased. This phenomenon is more prominent in children with MPP with special-purpose, and the level of MP antigen. MP infection causes NK cell-derived IL-4 levels were significantly increased, and the symbiotic mutualism, thereby aggravating allergic symptoms.