CD4＋CD25＋FOXP3＋调节性 T细胞在牛奶蛋白过敏发生及耐受中的作用

摘要

目的：探讨CD4＋CD25＋FOXP3＋调节性T细胞在牛奶蛋白过敏患儿发病及耐受过程中的作用。方法选取2013年1月至2015年1月东南大学医学院附属江阴市人民医院儿科明确诊断牛奶蛋白过敏的患儿20例，健康对照组20例，牛奶蛋白过敏患儿予深度水解或完全水解蛋白配方粉喂养6个月，6个月后行食物激发试验，过敏耐受者15例，耐受失败者3例。治疗前后测定外周血CD4＋CD25＋FOXP3＋调节性T细胞的水平，分析比较牛奶蛋白过敏患儿治疗前、治疗后及与对照组之间CD4＋CD25＋FOXP3＋调节性T细胞的差异，并比较治疗后过敏耐受患儿和耐受失败患儿CD4＋CD25＋FOXP3＋调节性T细胞的差异。结果牛奶蛋白过敏患儿CD4＋CD25＋FOXP3＋调节性T细胞水平明显低于对照组患儿（3．73±0．42％ vs 6．90±0．35％，t＝2．22，P＜0．05）；治疗后CD4＋CD25＋FOXP3＋调节性T细胞水平较治疗前明显升高（5．18±0．81％ vs 3．73±0．42％，t＝2．10， P＜0．05）；治疗后牛奶蛋白耐受患儿CD4＋CD25＋FOXP3＋调节性T细胞水平明显高于耐受失败患儿（5．36±0．76％ vs 4．28±0．36％，t＝2．31，P＜0．05）。结论 CD4＋CD25＋FOXP3＋调节性T细胞有助于减少牛奶蛋白过敏的发生，并帮助诱导免疫耐受。%Objective To explore the roles of CD4 +CD25 +FOXP3 +regulatory T cells in the pathogenesis of and tolerance induction against cow’s milk allergy.Methods A total of 20 children who were allergic to cow’s milk were chosen as research objects.All these children were diagnosed at the department of pediatrics in Jiangyin People ’ s Hospital Affiliated to Southeast University Medical College from January 2013 to January 2015.Over the same period, 20 healthy children were selected in control group .Children with cow’s milk allergy were given completely hydrolyzed or deeply hydrolyzed protein formulas for six months .Six months later , a food challenge test was performed.Among them, 15 children were tolerant to cow’s milk while 3 children were not.Levels of CD4 +CD25 +FOXP3 +regulatory T cells in peripheral blood were measured before and after treatment .Besides, comparison of the CD4 +CD25 +FOXP3 +regulatory T cells in children with cow’s milk allergy before and after the treatment was carried out .In addition, intergroup comparison of the CD4 +CD25 +FOXP3 +regulatory T cells was conducted .Moreover, comparison of the CD4 +CD25 +FOXP3 +regulatory T cells was also performed between children who developed tolerance to cow ’ s milk and who were still allergic to cow ’ s milk.Results The level of CD4 +CD25 +FOXP3 +regulatory T cells was significantly lower in children with cow ’s milk allergy than the control group (3.73 ±0.42% vs 6.9 ± 0.35%, t=2.22, P<0.05).After treatment, a remarkable increase was identified in the level of CD 4 +CD25 +FOXP3 +regulatory T cells when compared with the situation before treatment (5.18 ±0.81% vs 3.73 ±0.42%, t=2.10, P<0.05).After treatment, the level of CD4+CD25 +FOXP3 +regulatory T cells was significantly higher in children who developed tolerance to cow ’ s milk than those who were still allergic to cow’s milk (5.36 ±0.76%vs 4.28 ±0.36%,t=2.31,P<0.05).Conclusion CD4 +CD25 +FOXP3 +regulatory T cells can help to reduce the incidence of allergy to cow ’ s milk protein and help to trigger immune tolerance .