流式细胞磁珠微阵列法检测血清中细胞因子水平在稳定期和急性加重期哮喘中的意义

 目的   探讨流式细胞磁珠微阵列法(cytometric beads array,CBA)检测血清中细胞因子水平在稳定期和急性加重期哮喘中的意义。
方法   纳入慢性持续期哮喘40例,急性发作期哮喘22例,健康人 18例。抽取外周血2 mL,采用CAB法检测外周血清中细胞因子水平,并分析各细胞因子特征及与临床数据的相关性。全自动血细胞及生化仪检测血常规,C反应蛋白和降钙素原。结果   定制含7种细胞因子微球(分别为IL-5,IL-6,IL-10,IL-13,IL-17,TNF-α,IFN-γ)的CBA试剂盒。与健康人相比,7种细胞因子在慢性持续期哮喘无明显改变。急性发作期哮喘细胞因子升高分为5种亚群,分别为IL-6升高型(22.8%)、IL-6/TNF-α双高型(13.6%)、IL-5升高型(31.8%)、IL-17升高型(占13.6%)及细胞因子正常型(占18.2%)。其中,IL-6、TNF-α明显升高,较健康人分别升高了6.28~12倍和17.3倍。IL-6升高型、IL-6/TNF-α升高型与白细胞及C反应蛋白呈正相关(R2=0.63,R2=0.67;P<0.05)。结论   CBA法可快速检测哮喘血清标本的多种细胞因子水平,细胞因子在慢性持续期无明显升高,但IL-6、TNF-α、WBC和CRP的综合指标有助于判断由细菌感染诱发的急性加重,并快速指导抗生素的使用。 

The significance of cytometric beads array in detecting serum cytokine level for steady and acute exacerbation asthma

Objective  To detect cytokines in serum for chronic asthma and acute exacerbation by cytometric beads array method (CBA), and to analyze characteristics of cytokine subgroup and their relation to clinical data.Methods  Fourty chronic asthma,22 acute exacerbation of asthma and 18 healthy subjects were included.A little amount of blood was drawn from each subject (2 mL) and used for measuring cytokines by CBA to analyze their characteristics and correlation with clinical data.Regular blood test,C reaction protein and procalcitonin were measured by full automatic blood cell and biochemical analyzer.Results  CBA kit of cytokine panels were custom-made,which included IL-5,IL-6,IL-10,IL-13,IL-17,TNF-α and IFN-γ.No differences were found in cytokine levels in chronic asthma when compared with healthy subjects.However, in acute exacerbation phase,there were 5 cytokine subgroups which were high IL-6 (22.8%),high IL-6/TNF-α(13.6%),high IL-5 (31.8%),high IL-17(13.6%) and normal cytokine (18.2%).The levels of IL-6 and TNF-α increased  6.28-12 folds and 17.3 folds respectively compared with healthy subiects. High IL-6 and High IL-6/TNF-α were positively correlated with WBC and CRP (R2=0.63,R2=0.67:P<0.05).Conclusion   CBA was a reliable way to detect muti-cytokines in asthma serum in a short time.No differences were found in cytokine levels in chronic asthma.However,the specific cytokine panel (IL-6,TNF-α,WBC and CRP) may be helpful to identify the acute exacerbation caused by bacterial and guide appropriate antibiotic therapy.