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目的观察过敏性紫癜(HSP)病儿外周血树突细胞(DC)产生IL12的变化,并探讨其对TH1/TH2平衡的影响及在HSP发病机制中的意义。方法应用酶联免疫吸附试验(ELISA)检测60例HSP病儿(HSP组)及21例健康儿童(对照组)血浆干扰素γ(IFNγ)、白细胞介素4(IL4)、白细胞介素12(IL12)水平。并对其中22例HSP病儿及21例健康儿童外周血单个核细胞(PBMC)进行体外培养以诱生出DC,用ELISA法检测培养上清液中IL12水平,同时应用间接免疫荧光法检测CD1a+细胞表达率。结果①HSP组血浆IFNγ水平低于对照组(30.59±11.27pg/mLvs43.38±19.19pg/mL,P<0.01),IL4水平高于对照组(45.08±9.19pg/mLvs32.95±7.10pg/mL,P<0.01),IFNγ/IL4比值低于对照组(0.70±0.28vs1.33±0.57,P<0.01),IL12水平低于对照组(153.95±91.88pg/mLvs323.06±162.34pg/mL,P<0.01);HSP组和对照组各自血浆中IL12水平与IFNγ水平呈正相关(P<0.01,0.05),与IL4水平无相关性(P>0.05),与IFNγ/IL4比值呈正相关(P<0.01)。②HSP组培养上清液IL12水平低于对照组(357.06±153.56pg/mLvs489.80±213.45pg/mL,P<0.05),且与血浆IL12水平呈正相关(P<0.01)。③HSP组CD1a+细胞表达率低于对照组(27.42±10.75)%vs(35.68±12.18)%,(P<0.05),与培养上清液和血浆IL12水平皆呈正相关(P<0.01)。结论HSP病儿存在TH1/TH2平衡失调,TH1功能的下降与血浆IL12水平低下呈正相关,而后者又与DC数量减少和/或功能低下关系密切,表明HSP病儿外周血DC数量减少和/或功能低下间接导致了TH1/TH2平衡的失调。
Objective To observe the changes of IL12 produced by peripheral blood dendritic cells (DCs) in children with Henoch-Schonlein purpura (HSP) and to explore its effect on the balance of TH1 / TH2 and its significance in the pathogenesis of HSP. Methods Serum levels of IFNγ, IL-4 and IL-12 in 60 HSP children and 21 healthy children (control group) were detected by enzyme linked immunosorbent assay (ELISA) IL12) levels. In addition, peripheral blood mononuclear cells (PBMCs) from 22 children with HSP and 21 healthy children were cultured in vitro to induce DCs. The levels of IL12 in culture supernatants were detected by ELISA, and CD1a + cells were detected by indirect immunofluorescence Expression rate. Results ① The plasma levels of IFNγ were lower in the HSP group than those in the control group (30.59 ± 11.27pg / mL vs 43.38 ± 19.19pg / mL, P <0.01), and IL4 levels were significantly higher than those in the control group (45.08 ± 9.19pg / mL vs 32.95 ± 7.10pg / mL (P <0.01), the ratio of IFNγ / IL4 was lower than that of the control group (0.70 ± 0.28vs1.33 ± 0.57, P <0.01), and the level of IL12 was lower than the control group (153.95 ± 91.88pg / mL vs323.06 ± 162.34pg / (P <0.01). There was a positive correlation between plasma IL-12 level and IFNγ level in HSP group and control group (P <0.01, 0.05), no correlation with IL4 level (P> 0.05) 0.01). ② The level of IL12 in culture supernatant of HSP group was lower than that of control group (357.06 ± 153.56 pg / mL vs 489.80 ± 213.45 pg / mL, P <0.05), and positively correlated with plasma IL12 level (P <0.01). (3) The expression of CD1a + cells in HPSP group was lower than that in control group (27.42 ± 10.75)% vs (35.68 ± 12.18)%, (P <0.05), and positively correlated with IL12 level in culture supernatant and plasma (P <0.01). Conclusions There is imbalance of TH1 / TH2 in children with HSP, the decrease of TH1 function is positively correlated with the low level of plasma IL12, and the latter is closely related to the decrease of DC quantity and / or hypofunction. Dysfunction indirectly leads to imbalance of TH1 / TH2 balance.