乌鲁木齐地区维、 汉族儿童哮喘与ADAM33 基因多态性的相关性

目的探讨乌鲁木齐地区维、汉族儿童支气管哮喘与ADAM33基因多态性的相关性。方法选取同期3~15岁于乌鲁木齐地区生活的86例维族和111例汉族哮喘患儿,同时纳入64例汉族、56例维族健康儿童为对照组;采用聚合酶链反应对ADAM33基因V4、T2位点进行单核苷酸多态性(SNP)分型,并对其中部分进行基因检测验证。结果哮喘组和对照组之间,ADAM33基因V4、T2位点三种基因型的分布差异有统计学意义(P均0.01);V4位点哮喘组CC基因型频率较高,与G等位基因个体比较,C等位基因携带者儿童发生哮喘的风险增加1.51倍(95%CI:1.10~2.09);T 2位点哮喘组AA基因型频率较高,与G等位基因个体比较,A等位基因携带者儿童发生哮喘的风险增加1.96倍(95%CI:1.32~2.91)。汉族儿童中,哮喘组和对照组之间ADAM 33基因V 4、T 2位点三种基因型分布的差异无统计学意义(P均0.05);而维族儿童中,V 4、T 2位点三种基因型分布的差异有统计学意义(P均0.05)。结论 ADAM 33基因V 4、T 2位点与乌鲁木齐地区维族儿童哮喘发病相关。     

Low levels of interferon‐γ in nasal fluid accompany raised levels of T‐helper 2 cytokines in children with ongoing allergic rhinitis

The T‐helper 2 (Th2) cytokines interleukin‐(IL‐) 4, IL‐5, IL‐6, IL‐10 and the Th1 cytokine IFN‐γ and their associations with eosinophils, eosinophilic cationic protein (ECP) and immunoglobulin (Ig) E were studied in nasal lavage fluid from 60 school children with allergic seasonal rhinitis and 36 nonatopic healthy controls, before and during the pollen season. Eosinophil differential counts and IgE increased significantly in the patients during the pollen season. The eosinophil differential counts, ECP and IgE were all significantly higher during the season than in specimens simultaneously obtained from the nonatopic controls. Before season, the levels of ECP and IgE, but not eosinophils, were significantly higher in the patients than in the controls. During the season the nasal lavage fluid levels of IFN‐γ were significantly lower and the IL‐4/IFN‐γ quotients significantly higher in the allergic than in the control children. In the allergic children, but not in the controls, the nasal fluid levels of the Th2 cytokines IL‐4, IL‐5 and IL‐10 increased during the season, and together with IL‐6, were correlated with the differential counts of eosinophils, and with the levels of ECP and IgE. These findings are compatible with the hypothesis that a deficient release of the Th1 cytokine IFN‐γ plays an important role in the pathogenesis of allergic inflammation. Regardless of whether the defective IFN‐γ secretion is primary or a consequence of suppression by other cytokines, it will in the atopic subjects enhance the release of Th2 cytokines, which in turn will facilitate the development of allergic inflammation.     

Relation between serum IL‐4, IL‐13 and IFN‐γ levels and recurrence of wheezing episodes in infants with acute bronchiolitis

Lower respiratory tract infections are the most important factors among various causes which trigger wheezing in the first year of life. The factors associated with episodic wheezing in children with acute bronchiolitis are still subjects of research. Infections, environmental factors, immunologic mechanisms are sorted as etiologic risk factors of episodic wheezing. We aimed to investigate the relationship between serum interleukin (IL)‐4, IL‐13 and γ‐interferon (IFN‐γ) levels and recurrence of wheezing episodes in infants with acute bronchiolitis. One hundred twenty infants between 3 and 36 months with acute bronchiolitis enrolled in the study. Personal histories, clinical and laboratory data of infants were recorded. The patients were followed for a year. Venous blood samples were obtained to determine serum IL‐4, IL‐13, and IFN‐γ levels during acute bronchiolitis episode. The number of wheezing episodes was significantly higher in infants with a positive family history of allergy. A statistically significant correlation was determined between serum IL‐13 levels of infants and number of wheezing episodes. High serum IL‐13 levels and a positive history of allergy may have important roles in the recurrence of acute bronchiolitis.     

毛细支气管炎CD4+CD25+调节性T细胞和Foxp3 mRNA表达及与IgE关系

目的：通过对呼吸道合胞病毒(RSV)毛细支气管炎患儿CD4+CD25+调节性T细胞（CD4+CD25+Treg）、Foxp3 mRNA的表达、IgE合成的检测,以探讨其在RSV毛细支气管炎发病机制中的作用。方法：在RSV检测阳性的57例毛细支气管炎患儿中,运用流式细胞仪检测外周血CD4+CD25+Treg的比例,RT-PCR检测Foxp3 mRNA的表达量、ELISA法检测血清总IgE含量。25例健康儿童作为对照组。结果：毛细支气管炎患儿外周血CD4+CD25+Treg细胞数量减少,特应性体质（7.7±1.6%）和非特应性体质组（8.8±2.1%）均低于对照组（10.5±1.6%）（P均<0.01）。毛细支气管炎特应性体质和非特应性体质组外周血Foxp3 mRNA表达亦均低于对照组（P<0.01）。而血清总IgE含量毛细支气管炎特应性体质（241.2±102.5 IU/mL）和非特应性体质组(125.5±63.2 IU/mL)均高于对照组(27.2±10.5 IU/mL)（P<0.01）。外周血CD4+CD25+Treg细胞数量、Foxp3 mRNA表达及血清总IgE含量在毛细支气管炎特应性体质和非特应性体质组之间差异有显著性意义。CD4+CD25+Treg、Foxp3 mRNA与血清IgE水平之间相关密切,r=-0.70,-0.79(均P<0.01)。结论：毛细支气管炎外周血淋巴细胞CD4+CD25+Treg和Foxp3 mRNA表达降低,二者低水平表达使IgE合成增多,共同参与了RSV毛细支气管炎的发病。［中国当代儿科杂志,2009,11（5）：349-353］