川崎病外周血中CD4＋CD25＋调节性T细胞与其他免疫细胞的关系研究

目的 探讨CD4＋CD25＋调节性T细胞在川崎病发病机制中作用.方法 以2006年12月～2008年2月入院的32例KD患儿为研究对象,以年龄匹配的30例儿童作为对照组（其中15例急性呼吸道感染的发热患儿为非KD发热组,15例健康体检患儿为健康组）,KD患儿分别于静脉注射丙种球蛋白（IVIG）治疗前和IVIG治疗后热退2～3天取外周血,用流式细胞仪测定外周血单个核细胞CD4＋CD25＋调节性T细胞及其他免疫细胞比例,并分析其关系.结果 急性期KD患儿外周血CD4＋CD25＋调节性T细胞比例与非KD发热患儿和健康对照组相比均明显降低（P〈0.01）.而IVIG治疗后热退2～3天,CD4＋CD25＋调节性T细胞比例明显升高,接近于正常水平.同时,急性期KD患儿外周血中,CD3＋CD4＋、CD19＋CD23＋细胞业群比例明显增高,而CD3＋CD8＋、CD16＋CD56＋细胞亚群比例明显下降.在IVIG治疗后热退2～3天,CD3＋CD4＋,CD19＋CD23＋细胞亚群比例均有明显的下降,CD3＋CD8＋细胞比例升高,但未见CD16＋CD56＋细胞比例的升高.且在KD急性期,CD3＋CD4＋、CD19＋CD23＋细胞亚群比例与CD4＋CD25＋调节性T细胞比例成负相关性（P〈0.01）,而CD3＋CD8＋、CD16＋CD56＋细胞亚群比例则与其没有明显的相关性（P〉0.05）.在IVIG治疗后热退2～3天,CD3＋CD4＋、CD19＋CD23＋细胞亚群比例仍与CD4＋CD25＋凋节性T细胞比例呈负相关（P〈0.01）.结论 CD4＋CD25＋调节性T细胞可能通过对体内免疫细胞的调控参与了KD的发病机制.

Study of Relation between CD4+CD25+Regulatory T Cells and Other Immune Cells Subsets in Children with Kawasaki Disease

Objective To investigate the role of CD4＋CD25＋ regulatory T cells in the pathogenesis of Kawasaki disease（KD）. Methods Thirty-two patients with Kawasaki disease and thirty age-matched control subjects（15 febrile patients with common infection disease and 15 healthy children） were included in the study. Applying flow cytometer（FCM） to determine the proportion of CD4＋CD25＋ regulatory T cells and immune cells subsets.All patients with KD in this study were detected two times （before the intravenous immunoglobulin（IVIG） treatment and 2-3 days after relief of high fever due to IVIG treatment）. Results Compared with febrile patients with common infection disease（mean 6.37%） and healthy children（mean 7.45%）,the proportion of CD4＋CD25＋ regulatory T cells in the KD children at acute phase（mean 4.40%） decresed significantly,while at defervescence phase,it increased obviously（mean 6.88%）.The proportion of CD3＋ CD4＋ ,CD19＋ CD23＋ cells in the KD childrenat acute phase incresed significantly,but the decreased proportion of CD3＋CD8＋,CD16＋ CD56＋ cells in these patients（P〈0.01）. 2- 3 days after relief of high fever due to IVIG treatment,the proportion of CD3＋CD4＋,CDI 9＋CD23＋ decreased obviously（P〈0.01） and proportion of CD3＋CD8＋ ceils increased significantly（P〈0.0 l）,but as regard to the proportion of CD16＋CD56＋ cells,no significant change was found（P〉0.05）.Negative relation was found between the proportion of CD3＋CD4＋,CDI9＋CD23＋ and the proportion of CD4＋CD25＋ regulatory T cells at acute phase of KD（P〈0.01）,but there were no significant relation between the proportion of CD3＋CD8＋,CD16＋CD56＋ cells and the proportion of CD4＋CD25＋ regulatory T cells（P〉0.05）.2 -3 days after relief of high fever due to IVIG treatment,the negative relation were also found between the proportion of CD3＋CD4＋,CD19＋CD23＋ cells and the proportion of CD4＋CD25＋ regulatory T cells（P〈0.01）.Conclusion CD4＋CD25＋ regulatory T cells might take part in the pathogenesis of KD.