产妇血清和新生儿脐带血中IgE、白细胞介素4和白细胞介素18水平与特应性皮炎的关系研究

目的 探讨产妇血清和新生儿脐带血中的IgE、白细胞介素4（IL-4）和白细胞介素18（IL-18）水平与特应性皮炎（AD）的相关性。 方法 于2009—2011年通过问卷调查的方法建立921个出生队列，在生产住院时采集产妇静脉血、在新生儿出生时采集脐带血冻存待检。婴儿出生后12和24个月随访，35例诊断为AD， 随机选出队列中未诊断AD的儿童35例为对照组。应用ELISA方法检测对照组及患者组产妇血清和新生儿脐带血中的IgE、IL-4和IL-18水平，评价上述指标在预测AD发生中的作用。 结果 35例AD患儿母亲血清总IgE（425.34 ± 278.38 IU/ml）、脐带血总IgE（418.23 ± 256.76 IU/ml）高于对照组（分别为87.12 ± 47.48、81.77 ± 45.26 IU/ml），二组间差异有统计学意义（t值分别为7.29、7.88，均P ＜ 0.01）；AD患儿母亲血清IL-4水平（316.28 ± 80.92 ng/L）明显高于对照组（188.79 ± 61.92 ng/L），两组比较，t = 25.77，P ＜ 0.01。AD患儿脐带血IL-4水平（356.73 ± 91.01 ng/L）亦明显高于对照组（191.45 ± 73.65 ng/L），两组比较，t = 18.90，P ＜ 0.01。AD患儿母亲血清IL-18水平（425.38 ± 49.36 ng/L）明显高于对照组（141.7 ± 29.91 ng/L），两组比较，t = 42.73，P ＜ 0.01；脐带血IL-18水平与对照组差异无统计学意义（P ＞ 0.05）。 结论 产妇血清中总IgE、IL-4和IL-18以及脐带血中总IgE和IL-4与儿童AD的发生有关。

Analysis of relationship between atopic dermatitis and IgE,interleukin-4 and IL-18 levels in maternal serum and umbilical cord blood

Zeng Sanwu*, Wang Deling, Zou Yingxue, Tang Naijun, Chen Xu, Wei Wenguo, Jin Jingji, Qi Fang, Suo Danfeng. *Department of Dermatology, Tianjin First Center Hospital, Tianjin 300192, ChinaCorresponding author: Zeng Sanwu, Email: sanwuzeng@sohu.com 【Abstract】 Objective To explore the relationship between atopic dermatitis （AD） and IgE, interleukin （IL）-4 and IL-18 levels in maternal serum and umbilical cord blood. Methods A total of 921 mother-newborn pairs were recruited to a birth cohort during 2009－2011 through a questionnaire survey. Venous blood samples were collected from the mothers during birth hospitalization, and umbilical cord blood samples from the newborns at birth. All of these blood samples were cryopreserved. Thirty-five infants, who were diagnosed with AD during follow up at 12 and 24 months after birth, with their mothers served as the patient group; 35 infants without AD were selected randomly from the remaining infants, and served as the control group with their mothers. Enzyme-linked immunosorbent assay （ELISA） was performed to detect the levels of IgE, IL-4 and IL-18 in serum samples from the mothers of these 70 infants as well as in their umbilical cord blood samples, so as to evaluate the roles of these indexes in predicting the occurrence of AD. Results Compared with the control group, the patient group showed higher total IgE levels in maternal serum （（425.34 ± 278.38） vs. （87.12 ± 47.48） IU/ml, t = 7.29, P < 0.01） and umbilical cord blood （（418.23 ± 256.76） vs. （81.77 ± 45.26） IU/ml, t = 7.88, P < 0.01）. Increased IL-4 level was also observed in maternal serum （（316.28 ± 80.92） vs. （188.79 ± 61.92） ng/L, t = 25.77, P < 0.01） and umbilical cord blood （（356.73 ± 91.01） vs. （191.45 ± 73.65） ng/L, t = 18.90, P < 0.01） in the patient group compared with the control group. The IL-8 level was significantly higher in maternal serum in the patient group than in the control group （（425.38 ± 49.36） vs. （141.7 ± 29.91） ng/L, t = 42.73, P < 0.01）, but similar in umbilical cord blood between the two groups （P > 0.05）. Conclusion Total IgE and IL-4 levels in maternal serum and umbilical cord blood as well as IL-18 level in maternal serum are related to the occurrence of childhood AD.