摘要
目的 研究静脉注射免疫球蛋白 (IVIG)对川崎病急性期治疗前、后辅助T淋巴细胞 1/辅助T淋巴细胞 2 (TH1/TH2 )功能平衡状态的影响。方法 采用ELISA法及流式细胞仪技术 (FACS)检测了 15例川崎病患儿急性期IVIG(剂量为 1g/kg,一次输入 )治疗前外周血浆IgE、外周血单个核细胞(PBMC)经培养 72h产生白细胞介素 4(IL 4 )、γ干扰素 (IFN γ)水平及CD4 T细胞膜蛋白CD3 0 的表达率 ,并与IVIG治疗后 (3～ 5d)及对照组的 15例门诊体检正常儿童比较。结果 川崎病患儿急性期IVIG治疗前CD4 T细胞CD3 0 表达率为 (16 9± 7 5 ) %、治疗后为 (3 8± 4 0 ) %;对照组为 (3 0± 1 8) %,IVIG治疗前与治疗后差异有显著性 (t =7 0 2 ,P <0 0 1) ,治疗前极显著高于对照组 (u =5 38,P <0 0 1) ,治疗后与对照组的差异无显著性 (u =0 4 7,P >0 0 5 )。治疗前PBMC培养上清IL 4水平 [(146± 2 7)ng/L]高于治疗后 [(5 4± 2 5 )ng/L],差异有极显著性 (t=9 6 5 ,P <0 0 1)。对照组 [(6 7± 2 4)ng/L]与治疗前的差异有极显著性 (u =5 2 7,P <0 0 1)、与治疗后差异无显著性 (u =0 72 ,P >0 0 5 )。治疗前IFN γ水平 [(6 6 8± 312 )ng/L]与治疗后 [(72 3± 46 3)ng/L]无显著性差异 (t=0 78,P >0 0 5 ) ,治疗前与对照组 [
Objective When intravenous immunoglobulin (IVIG) given during the acute phase of Kawasaki disease (KD), rapidly reverses clinical symptoms and prevents cardiac disease. The mechanism of IVIG′s therapeutic and prophylactic activity in KD is unknown but is assumed to involve immune mechanisms. The present study aimed at investigating effects of IVIG on T H1/T H2 functional state and mechanism of immunologic therapy of the acute phase from children with KD. Methods The levels of IL-4 and INF-γ in the supernatants of cultured peripheral blood mononuclear cells (PBMC) for 72 hours , or plasma IgE were measured by using ELISA and CD + 4CD + 30 T cells of cultured PBMC for 72 hours were analyzed by using FACS in the pre- or post-treatment (3～5days) with IVIG during from the acute phase 15 children with KD (male 9, female 6, and age 2.3±1.5 years), respectively. Fifteen healthy children (male 8, female 7, and age 2.6±1.4 years) were served as normal controls. Results Expression rate of CD4+CD30+ T cells was markedly higher in the pre-treatment specimens [(16.9±7.5)%] with IVIG during the acute phase of KD than in the post-treatment[(3.8±4.0)%](t=7.02, P<0.01) and than in normal controls [(3.0±1.8)%] (u=5.38,P<0.01). The IL-4 levels in the supernatants were significantly increased in the pre-treatment [(146±27)ng/L] than in the post-treatment specimens [(54±25)ng/L](t=9.65,P<0.01), and than in normal controls [(67±24)ng/L] (u=5.27,P<0.01). The INF-γ levels were not significantly different between the pre-treatment [(723±463)ng/L] and with the post-treatment [(668±312)ng/L] (t=0.78,P>0.05) specimens. But it was markedly lower in the pre-treatment than in normal controls specimens [(1 099±661)ng/L] (u=1.97,P<0.05). The levels of IgE were significantly decreased in the post-treatment plasma [(77±57 )ng/L] than in the pre-treatment plasma [(155±76)ng/L] by IVIG during the acute phase of KD (t=4.25,P<0.01), it was significantly different between the pre-treatment and normal controls specimens [(38±52)ng/L] (u=4.58,P<0.01). But it was not different between the post-treatment specimens and normal control (u=1.83,P>0.05). Conclusion T H1/T H2 functional state in the acute phase of KD was unbalanced. The effects of T H2 were increased. T H1/T H2 imbalance during the acute phase of KD was improved and the enhanced T H2 function were rapidly reversed by IVIG.
出处
《中华儿科杂志》
CAS
CSCD
北大核心
2002年第2期75-77,共3页
Chinese Journal of Pediatrics
关键词
川崎病
免疫球蛋白类
TH1/TH2
CD30抗原
儿童
Mucocutaneous lymph node syndrome
Immunoglobulins, intrarenous
T H1 cells/T H2 cells
Antigens, CD 30
