舌下免疫治疗对尘螨过敏哮喘患儿Th17/Treg平衡的影响

摘要

Objective To explore the effect of sublingual immunotherapy (S-LIT) on the balance of Th17/Treg in children with mite allergic asthma. Methods All 124 cases with mite allergic asthma were randomly divided into two groups, the control group (62 cases) was treated with ladder type inhalation, and the treatment group (62 cases) was administered of dust mite drops on the basis of conventional treatment. The peripheral frequency of Th17 cell and Treg cell of all the subjects (before and after treatment) were detected by flow cytometry, the serum cytokine IL-10、IL-17 levels wer analyzed by ELISA. Results After 1 year treatment, the Th17 cells in treatment group (1.50 %±0.87 %) was significantly lower than that before treatment (3.39 % ± 1.58 %), and less than that of the control group after 1 year of treatment (2.42 %±1.32 %) (P <0.01);after 1 year treatment, the proportion of Treg cells in treatment group (4.05 %±1.36 %) was significantly higher than that before treatment (2.33 ± 0.81%), and more than that of the control group after 1 year of treatment (2.87 %± 0.87 %) (P <0.01). After 1 year treatment, the serum IL-10 levels in treatment group (64.76±27.79 pg/mL) was significantly higher than that before treatment (36.32 ± 11.53 pg/mL), and more than that of the control group after 1 years of treatment (50.32 ± 10.97 pg/mL) (P <0.01);after 1 year treatment, the serum IL-17 levels in treatment group (20.45±8.35 pg/mL) was significantly lower than that before treatment (86.48 ± 28.19 pg/mL), and significantly less than that of the control group after 1 year of treatment (46.32 ± 12.43 pg/mL) (P <0.01). After 1 year treatment, the Childhood Asthma Control Test (C-ACT)score in the treatment group (24.35 ± 8.47) was significantly higher than the control group (20.13 ± 6.86) (P <0.05). Conclusions SLIT can decrease airway inflammation and correct the imbalance of Th17/Treg in children with mite, allergic asthma.%目的 观察舌下免疫治疗(SLIT)对尘螨过敏哮喘患儿Th17/Treg平衡的影响.方法 124例尘螨过敏哮喘患儿随机分为观察组62例和对照组62例,两组患儿均根据病情调整吸入性糖皮质激素治疗方案,观察组加用粉尘螨滴剂舌下含服,治疗1年.比较两组治疗前后Th17和Treg细胞比例以及血清IL-10和IL-17水平差异.结果 在治疗半年和1年后,观察组(中途退出8例,最终54例)Th17细胞比例和血清IL-17水平均低于对照组,Treg细胞比例和血清IL-10水平均高于对照组,观察组儿童哮喘控制测试(C-ACT)评分均高于对照组,差异有统计学意义(P<0.05).治疗前、治疗半年和1年后三个时间点之间比较,对照组及观察组的Th17和Treg细胞比例、血清IL-10和IL-17水平以及C-ACT评分的差异均有统计学意义(P均<0.001).对照组及观察组的Th17细胞比例和血清IL-17水平随时间出现下降趋势,各时间点间两两比较差异有统计学意义(P均<0.05);对照组及观察组的Treg细胞比例和血清IL-10水平随时间出现升高趋势,除了对照组在治疗前、治疗半年后间的差异无统计学意义以外,其余时间点间两两比较差异均有统计学意义(P均<0.05).观察组和对照组C-ACT评分随时间出现升高趋势,各时间点间两两比较差异有统计学意义(P均<0.05);结论 粉尘螨滴剂可减轻尘螨过敏哮喘患儿气道炎症及纠正Th17/Treg免疫失衡.