协同刺激分子CD28/B7及CD40/CD40L在哮喘特异性免疫治疗中的作用

目的探讨协同刺激分子CD28／B7—1、CD28／B7—2及CD40／CD40L在哮喘发病中的作用及在特异性免疫治疗前后表达水平的变化。方法选择30例哮喘患者为实验组，30例健康人群为对照组。采用流式细胞仪方法比较两组间T、B淋巴细胞表面CD28／B7—1、B7—2及CD40／CD40L的表达及与血清总IgE水平的相关性，以及哮喘患者特异性免疫治疗前后T、B淋巴细胞表面CD28／B7—1、B7—2及CEl40／CEl40L的表达水平。结果与健康人群相比，哮喘患者CD28、CD40L、B7—2及CD40表达水平均增高。血清总IgE水平与T淋巴细胞表达CD40L水平呈正相关。特异性免疫治疗6个月后，哮喘患者T、B淋巴细胞表达的CD28／B7—2及CD40／CD40L水平均有所下调，但均未达正常水平。结论协同刺激分子CD28／B7—2及CD40／CD40L表达水平的上调在哮喘发病中可能起重要作用，特异性免疫治疗能下调哮喘患者CD28／B7-2及CD40／CD40L的表达水平，并可能由此间接下调血清总IgE水平，起到相应的治疗作用。

Role of costimulatory molecules CD28/B7 and CD40/CD40L in specific immunotherapy of allergic asthma

Objective To study the role of costimulatory molecules CD28/B7 and CD40/CD40L in asthma patients andthe expression levels before and after specific immunotherapy. Methyls Thirty allergic asthma patients served as observation group, and 30 healthy as control group. Cytoflowmetric analysis was done to compare the expression levels 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 levels and serum total IgE levels were analyzed. Results The expression levels of CD28/B7-2 and CD40/CD40L on T cells and B cells in asthma patients were significantly higher than in the controls, and serum levels of TIgE had a positive relationship with the expression levels of CD40L on T cells. After specific immunotherapy for 6 months, the expression levels of CD28/B7-2 and CD40/CD40L on T cells and B cells were decreased in asthma patients, but still higher than in the controls. Conclusion The up-regulated levels of costimulatory molecules CD28/B7-2 and CD40/CD40L on T cells and B cells may play an important role in the pathogenesis of asthma. Specific immunotherapy can down-regulate the expression of CD28/B7-2 and CD40/CD40L, and decrease the serum level of TIgE.