川崎病患者血中CD4~+CD25~+调节性T细胞与血清IL-4、IFN-γ水平关系

目的探讨CD4+CD25+调节性T细胞在川崎病(KD)发病机制中的作用。方法 KD组患儿32例;对照组30例中分为两组:非KD发热组15例为急性呼吸道感染的发热患儿,健康组15例为健康体检患儿。KD患儿分别于静注丙种球蛋白(IVIG)前和IVIG治疗后热退2~3天取外周血,用流式细胞仪测定CD4+CD25+调节性T细胞比例,用酶联免疫吸附法(ELISA)检测血清干扰素-γ(IFN-γ)、白细胞介素-4(IL-4)水平并分析其关系。结果急性期KD患儿外周血CD4+CD25+调节性T细胞比例(4.40±1.31)%]与非KD发热组(6.37±1.99)%]和健康对照组(7.45±3.18)%]相比均明显降低(P<0.01),而IVIG治疗后热退2~3天,CD4+CD25+调节性T细胞比例(6.88±2.50)%]明显升高,接近于正常水平。同时在KD急性期,血清IFN-γ、IL-4水平均明显升高,在IVIG治疗后热退2~3天无明显下降。且在KD急性期血清IFN-γ、IL-4水平与CD4+CD25+调节性T细胞比例成负相关性(r=-0.838,P<0.01)。在静注IVIG后热退2~3天,血清IFN-γ、IL-4水平与CD4+CD25+调节性T细胞比例无明显相关性(r分别为-0.04和-0.072,P>0.05)。结论 CD4+CD25+调节性T细胞可能通过对体内Th1和Th2细胞的调控参与了KD的发病机制。

A study of relation between CD4+CD25+ regulatory T cells and serum IFN-γ, IL-4 in children with Kawasaki disease

Objective To investigate the role of CD4+CD25+ regulatory T cells plays in the pathogenesis of Kawasaki disease(KD).Methods Thirty-two patients with KD and thirty control subjects(15 febrile patients without KD and 15 healthy children) were included in the study.The flow cytometry(FCM) was used to determine the proportion of CD4+CD25+ regulatory T cells and serum IFN-γ、IL4 were detected by ELISA method.All patients with KD in this study were detected two times before the intravenous immunoglobulin(IVIG) treatment and 2～3 days after relief of high fever due to IVIG treatment].The relationship among them were analysed.Results Compared with febrile patients without KD (6.37±1.99)%] and healthy children (7.45±3.18)%],the proportion of CD4+CD25+ regulatory T cells in the KD children at acute phase (4.40±1.31)%] decreased significantly(P<0.01),while at defervescence phase 2～3 days after IVIG treatment,it increased obviously (6.88±2.50) %],nearly to the normal level.Meanwhile serum IFN-γ、IL-4 increased obviously at acute phase of KD,and there was no significant decreasement of them 2～3 days after relief of high fever.Threr was negative relation between serum IFN-γ,IL-4 and the proportion of CD4+CD25+ regulatory T cells at acute phase of KD(r=-0.838,P<0.01),but there were no significant relation between them 2～3 days after relief of high fever due to IVIG treatment(r=-0.04 and-0.072,respectively,P>0.05).Conclusion CD4+CD25+ regulatory T cells might take part in the pathogenesis of KD by regulating Th1 and Th2 cells in vivo.