胞外体与婴儿巨细胞病毒感染的相关性

目的 研究婴儿感染巨细胞病毒(CMV)后体内胞外体(EXO)水平的变化,以及细胞因子IL-4、γ干扰素(IFN-γ)水平在CMV感染婴儿血清和(或)EXO中的变化,探讨CMV感染对婴儿免疫功能的影响以及EXO在CMV感染发生发展过程中的作用.方法 选择山东大学齐鲁医院儿科收治的53例CMV感染婴儿(CMV感染组),排除其他病毒感染及遗传代谢性疾病;42例非CMV感染同龄儿童为对照组.分别采用ELISA法检测其血清EXO水平及血清EXO中IL-4水平,以及血清中IFN-γ水平.结果 CMV感染组患儿血清EXO、IFN-γ水平均较对照组显著降低(Pa＜0.05),血清IL-4水平较对照组升高,但差异无统计学意义(P>0 05),EXO中IL-4水平较对照组显著升高(P<0.05);二组血清IL-4与EXO IL-4呈正相关(r=0.794,P=0.000),感染组血清IL-4与EXO IL-4呈显著正相关(r=0.902,P=0.000).结论 1.CMV可破坏人体正常的Th1/Th2平衡,Th2免疫应答占优势,Th1免疫应答受抑制.2.CMV感染后,与Th1细胞相关的细胞因子IFN-γ减少,而与Th2细胞相关的细胞因子IL-4增多.3.EXO可作为细胞因子IL-4分泌的方式,介导机体细胞免疫功能的降低和Th1/Th2失衡,导致免疫耐受和免疫抑制,从而使病毒难以清除,感染持续并慢性化.

Association of Exosome with Cytomegalovirus Infection in Infants

Objective To study the changes in the quantity of exosome(EXO),as well as the expressions of interleukin-4(IL-4) and interferon-γ(IFN-γ) in serum and/or EXO of infants with cytomegalovirus(CMV)infection,and to investigate the influence of CMV on immune function of infants and the role of EXO in the CMV infection.Methods Fifty-three infants with CMV infection(without other viral infection or hereditary diseases) who had been treated in the Department of Pediatrics,Qilu Hospital,were studied as the infection group,while 42 non-CMV infection infants were selected as control group.The quantity of EXO and the expressions of IL-4 and IFN-γ were detected in the 2 groups by enzyme-linked immunosorbent assay.Results Compared with control group,the levels of EXO and serum IFN-γ in the infection group were significantly decreased,and the differences between the both groups were significant(Pa<0.05).However,the IL-4 level in serum was higher than that in control group,but there was no significant difference(P>0.05),and the level of IL-4 in EXO of infants in CMV infection group were significantly higher than that in control group(P<0.05).Moreover,there was positive correlation between serum IL-4 and EXO IL-4(r=0.794,P=0.000),especially in the CMV infection group(r=0.902,P=0.000).Conclusions 1.CMV can promote dysregulation in the immune balance of Th1/Th2,leading to the dominance of Th2 immune response and the depression of Th1 immune response.2.After CMV infection,IL-4 is decreased,while IFN-γ is increased.3.EXO can inhibit immune function by promoting the secretion of IL-4 and make the CMV infection persistent.