变应性鼻炎患者协同刺激分子CD28/B7及CD40/CD40L的研究

目的:探讨变应性鼻炎患者外周血T、B淋巴细胞表面协同刺激分子CD28/B7及CD40/CD40L的表达及与血清总IgE(TIgE)、患者鼻部症状和嗜酸粒细胞阳离子蛋白(ECP)的关系,以及特异性免疫治疗的作用。方法:选择30例对尘螨过敏的变应性鼻炎患者为实验组,30例健康人为对照组。采用流式细胞仪方法检测实验组和对照组以及实验组22例患者特异性免疫治疗前后T、B淋巴细胞表面CD28/B7-1、CD28/B7-2及CD40/CD40L的表达。用UniCAP系统检测血清变应原特异性IgE、TIgE和ECP的含量。结果:与对照组相比,实验组T淋巴细胞表面CD28及CD40L的表达水平增高,B淋巴细胞表面的B7-2及CD40表达也增高。T淋巴细胞CD40L表达水平与血清TIgE水平呈正相关,B7-2表达水平与ECP呈正相关,CD28、B7-1及CD40的表达水平与TIgE、鼻部症状评分和ECP均无相关性。特异性免疫治疗6个月后,实验组T、B淋巴细胞表达的CD28/B7-2及CD40/CD40L水平均有所下调。结论:协同刺激分子CD28/B7-2及CD40/CD40L表达水平的上调在变应性鼻炎的发病中可能起到重要作用,特异性免疫治疗能下调变应性鼻炎患者T、B淋巴细胞表面CD28/B7-2及CD40/CD40L的表达水平,并可能由此间接下调血清TIgE水平,起到相应治疗作用。

A study of costimulatory molecules in allergic allergic rhinitis patients

Objective:To investigate the expression of costimulatory molecules CD28/B7 and CD40/CD40L in T and B lymphcytes as well as its relations with total IgE(TIgE),eosinophil cationic protein(ECP) in serum and nasal allergic symptoms in patients with allergic rhinitis(AR).The effect of specific immunotherapy(SIT) on them were also investigated.Method:Thirty allergic allergic rhinitis patients were chosen as observation group,and 30 healthy patients as control group.Cytoflowmetric analysis was used to compare the expression level of CD28/B7-1,B7-2 and CD40/CD40L on T cells and B cells in the two groups.The relationship between the CD28/B7-1,B7-2 and CD40/CD40L expression level and serum Total IgE,ECP level were analyzed.Result:The expression level of CD28/B7-2 and CD40/CD40L on T cells and B cells in allergic rhinitis patients were significantly higher than in the healthy,and serum level of TIgE has a positive relationship with the expression level of CD40L on T cells.ECP has a positive relationship with the expression level of B7-2 on B cells.The expression level of B7-1 showed no significant difference between the two groups.After specific immunotherapy for 6 months,the expression level of CD28/B7-2 and CD40/CD40L on T cells and B cells were decreased in allergic rhinitis patients but still higher than in healthy.Conclusions:The upregulated level of costimulatory molecules CD28/B7-2 and CD40/CD40L on T cells and B cells may play an important role in the pathogenesis of allergic rhinitis,specific immunotherapy can downregulate the expression level of CD28/B7-2 and CD40/CD40L,and decrease the serum level of TIgE,it may be a possible mechanism in the treatment of allergic rhinitis.