小儿哮喘花剥苔产生的免疫机制研究

目的:从免疫学角度探讨哮喘患儿花剥苔形成的机制.方法:采用免疫组化方法检测舌苔脱落上皮细胞中角蛋白13及bcl-2蛋白的含量.应用流式细胞术检测外周血CD4 及细胞趋化因子受体3(cell chemokine receptor-3, CCR-3)的表达量.采用放射免疫法检测血清中皮质醇的含量.结果:哮喘花剥苔组患儿外周血CD4 和CCR-3水平明显高于哮喘非花剥苔组及正常组(P＜0.05);哮喘花剥苔组、非哮喘花剥苔组血清中皮质醇含量低于其余各组(P＜0.05).哮喘花剥苔、非花剥苔组血清IgE水平明显高于其余各组(P＜0.05).哮喘花剥苔组、非哮喘花剥苔组舌苔上皮脱落细胞中角蛋白13的含量明显低于哮喘非花剥苔组、非哮喘非花剥苔组和正常对照组(P＜0.05).哮喘花剥苔组患儿舌苔上皮脱落细胞中bcl-2蛋白含量与其余各组比较无统计学差异.结论:花剥苔的形成与免疫反应密切相关,血清皮质醇水平降低、CD4 及CCR-3增多,可能促进了花剥苔的形成.同时,舌上皮细胞角化障碍及舌上皮细胞凋亡亦可能促进花剥苔的形成.

Immunological mechanism of exfoliative tongue fur in children with asthma

Objective: To explore the immunological mechanism of exfoliative tongue fur in children with asthma.Methods: Thirty-nine children with asthma,twenty-eight children with repetitive respiratory tract infection non-asthma and eleven healthy children were divided into five groups,which were asthma with exfoliative fur or with non-exfoliative fur groups,non-asthma with exfoliative fur or with non-exfoliative fur groups and normal control group.The concentrations of keratin 13 and bcl-2 in cells exfoliated from tongue fur were detected by immunohistochemical method.The expression levels of blood cell chemokine receptor-3 CCR-3 and CD4~ + were examined by flow cytometry,and the levels of serum cortisol and IgE were detected by radioimmunoassay.Results: The levels of blood CD4~ + and CCR-3 of children with asthma and exfoliative fur were higher than those in the asthma with non-exfoliative fur group and the normal control group P< 0.05. The serum level of cortisol in the groups of asthma with exfoliative fur and non-asthma with exfoliative fur were lower than that in the other groups P<0.05.The serum levels of IgE in asthma with exfoliative fur or with non-exfoliative fur groups were higher than that in the other groups P<0.05.Concentrations of keratin 13 in the cells exfoliated from tongue fur in the groups of asthma or non-asthma with exfoliative fur were lower than that of the other groups P<0.05.There was no significant difference of expression level of bcl-2 in the cells exfoliated from tongue fur among these five groups.Conclusion: There is a reasonably close relationship between the formation of exfoliative tongue fur and the immune system such as low level of serum cortisol and high levels of blood CD4~ + and CCR-3,which may all promote the formation of exfoliative fur.The disability of keratinization and apoptosis of epithelial cells of tongue may also be one cause for its formation.