T细胞亚群及相关细胞因子在复发性外阴阴道念珠菌病发病中的作用

目的探讨T细胞亚群及局部分泌物中相关的细胞因子在复发性外阴阴道念珠菌病发病机制中的作用。方法采用碱性磷酸酶-抗碱性磷酸酶(APAAP)桥联酶法技术,对28例外阴阴道念珠菌病(VVC)、35例复发性外阴阴道念珠菌病(RVVC)和31例健康对照者外周血进行T淋巴细胞亚群CD4+,CD8+细胞检测,ELISA法检测以上各组女性阴道分泌物中IL-12,IL-4和IFN-γ的表达水平。结果 RVVC组CD4+T淋巴细胞低于VVC组和对照组(P均<0.05),而CD8+T淋巴细胞均高于VVC组和对照组(P均<0.05)。VVC组IL-12水平明显高于RVVC组和对照组(P<0.05);IFN-γ水平在RVVC组、VVC组差异无统计学意义(P>0.05),但均高于对照组(P均<0.05);IL-4水平在三组间两两比较差异均无统计学意义(P>0.05)。结论复发性外阴阴道念珠菌病患者可能存在一定的免疫缺陷,Th1型和Th2型细胞因子的表达异常可能与外阴阴道念珠菌病的发病以及复发有关。

The Role of T cell Subsets and Cytokines Involved in the Pathogenesis of Recurrent Vulvovaginal Candidiasis

Objective To study the role of T cell subsets and cytokine involved in the vaginal secretions of vulvovaginal candidiasis patients in the pathogenesis of recurrent vulvovaginal candidiasis.Methods Alkaline phosphatase-anti-alkaline phosphatas(APAAP) was used to detect CD4+ and CD8+T lymphocytes of 28 cases vulvovaginal candidiasis(VVS),35 cases recurrent vulvovaginal candidiasis(RVVC) patients and 31 cases health control.The expression level of IL-4,IL-12,IFN-γ in the vaginal secretions from vulvovaginal candidiasis patients were detected by ELISA and compared with that from normal controls.Results CD4+ T ymphocytes in recurrent groups were lower than that of original and normal control groups,and CD8+T lymphocytes were higher than that of original and normal control groups.The level of IL-12 in original groups was the hightest in the three groups,while no significant difference in IFN-γ between recurrent and original groups was found,and yet higher than that in normal control groups.There was no significant difference in IL-4 in these three groups.Conclusions Certain immune deficiencies were found in the patients of recurrent vulvovaginal candidiasis.The abnormal expression of Th1 type and Th2 type cytokines may be associated with the morbidity and recurrence of vulvovaginal candidiasis.