外周血髓系抑制细胞和IL-10、IL-12与婴幼儿喘息相关性研究

发布时间：2018-07-11 10:09

本文选题：婴幼儿喘息 + 髓系抑制细胞　；参考：《郑州大学》2013年硕士论文

【摘要】：喘息是小儿最常见的呼吸道症状,小儿喘息性疾病是指有一组具有喘息症状的呼吸道综合征,由于年龄特异的病理生理特点,喘息在婴幼儿中常常反复发生,部分喘息是儿童哮喘的早期表现,但是目前婴幼儿喘息的发病机制尚不清楚。对于正在喘息发作的患儿来讲,判断是暂时性的喘息还是哮喘,仍是儿科临床工作中的难题。目的检测毛细支气管炎和反复喘息患儿外周血髓系抑制细胞(myeloid-derived suppressor cells,MDSCs)占单个核细胞比例、血清白介素10(Interleukin-10, IL-10)及血清白介素12(Interleukin-12, IL-12)水平,初步探讨其在婴幼儿喘息中的发病机制及其关系。材料和方法研究对象分为4组：毛细支气管炎组(毛支组)、反复喘息组(喘息组)、非感染对照组、肺炎对照组。选择从2010年10月至2012年6月就诊于郑大三附院儿内科门诊或病房住院的毛细支气管炎急性期患儿99例(男51例,女48例),年龄3月-2岁,平均年龄是1岁6月,至少具有高危因素之一的患儿52例为毛支Ⅰ组,无高危因素的患儿47例为毛支Ⅱ组(特应质高危因素是指：患儿自身有医生诊断的包括变应性皮炎、变应性鼻炎等变应性疾病或者父母双方或一方患有哮喘疾病史者)。同期选择急性发作期反复喘息患儿(均在过去的12个月内至少有3次喘息及以上发作或过去6个月内至少有2次喘息及以上发作)103例(男51例,女52例),年龄7月-2岁1月,平均年龄是1岁7月,根据我国2008年制定《儿童支气管哮喘诊断与防治指南》[’]中哮喘预测指数标准,将哮喘预测指数阳性的患儿入喘息Ⅰ组(50例),哮喘预测指数阴性的患儿入喘息Ⅱ组(53例)。随机选取同期本院同年龄组外科患疝气、肾结石等非感染性疾病术前患儿54例(男28例,女26例)作为非感染对照组,年龄6月-2岁4月,平均年龄1岁7月。选择同期在我院在门诊就诊或住院诊断为肺炎的患儿50例(男25例,女25例)作为支气管肺炎对照组,年龄6个月～2岁3月,平均1岁8月,均无特应质高危因素。各组儿童年龄、性别比较差异均无统计学意义(Pa0.05),各组儿童均为足月出生,排除肿瘤患儿,排除气道发育畸形患儿,近2周无感染疾病史,无免疫调节剂使用史,其家长均知情同意并征得医院伦理委员会同意。采用流式细胞术检测MDSCs在外周血单核细胞中的比例,采用ELISA(酶联免疫吸附实验)法检测外周血血清中IL-10、IL-12水平。统计学分析采用SPSS17.0统计软件完成,各组资料以(x±S)表示,组间差异性分析采用单因素方差分析、Bonferroni方法检验,相关分析采用Pearson直线相关分析,以a=0.05作为统计学的检验水准。结果 1.喘息Ⅰ组较喘息Ⅱ组相比,外周血MDSCs%、血清IL-10水平显著升高,血清IL-12水平显著降低(P0.05)；喘息Ⅱ组较肺炎对照组、非感染对照组相比,外周血MDSCs%、血清IL-10水平显著升高,血清IL-12水平显著降低(P0.05)。 2.毛支Ⅰ组较毛支Ⅱ组相比,外周血MDSCs%、血清IL-10水平显著升高,血清IL-12水平显著降低(P0.05)；毛支Ⅱ组较肺炎对照组、非感染对照组相比,外周血MDSCs%、血清IL-10水平升高,血清IL-12水平显著降低(P0.05)。 3.喘息Ⅰ组较毛支Ⅰ组相比,外周血MDSCs%、血清IL-10水平、IL-12水平均无明显差异(P0.05)；喘息Ⅱ组较毛支Ⅱ组相比,外周血MDSCs%、血清IL-10水平、血清IL-12水平均无明显差异(P0.05)。 4.肺炎对照组与非感染对照组相比,外周血MDSCs%、血清IL-10水平、IL-12水平无明显差异(P0.05)。 5.相关性分析：喘息组Ⅰ组和毛支Ⅰ组外周血MDSCs%和血清IL-10水平存在正相关,与血清IL-12水平呈负相关,喘息Ⅱ组、毛支Ⅱ组、肺炎对照组及非感染对照组MDSCs%与血清IL-10水平、血清IL-12水平均无相关性。结论 MDSCs可能通过上调IL-10水平,下调IL-12水平参与毛细支气管炎、反复喘息的发病机制。
[Abstract]:Wheezing is the most common respiratory symptom in children. Children's wheezing disease refers to a group of respiratory syndrome with wheezing symptoms. Due to age specific pathophysiology, wheezing often occurs repeatedly in infants and infants. Partial wheezing is an early manifestation of asthma in children, but the pathogenesis of infant wheezing is not yet clear. For children who are wheezing, judging whether they are transient wheezing or asthma is still a difficult problem in pediatric clinical work.
objective
The ratio of myeloid-derived suppressor cells (MDSCs) to mononuclear cells, serum interleukins 10 (Interleukin-10, IL-10) and serum interleukins 12 (Interleukin-12, IL-12) were detected in children with bronchiolitis and recurrent wheezing, and the pathogenesis and relationship of them in infants' wheezing were preliminarily discussed.
Materials and methods
The subjects were divided into 4 groups: the bronchiolitis group (Mao Zhizu), the repeated wheezing group (wheezing group), the non infected control group and the pneumonia control group. 99 cases (51 males and 48 females) were selected from October 2010 to June 2012 in the acute period of bronchiolitis hospitalized in the outpatient department of the Affiliated Hospital of Zheng Dasan Affiliated Hospital (51 males and 48 females), and the average age was -2 years old in the age of March. At least 1 years old in June, 52 children with at least one high risk factor were group I, and 47 cases with no high risk factors were group II Group (high risk factors of idiopathic allergic dermatitis, allergic rhinitis, allergic rhinitis, etc.).
Children with a history of asthma). At the same time, children with recurrent wheezing during the period of acute attack (at least 3 wheezing and above in the past 12 months or at least 2 wheezing or more episodes in the past 6 months in the past 6 months), 103 cases (51 men, 52 women), age July January, average age is 1 year July, according to our country in 2008 The guidelines for the diagnosis and prevention of bronchial asthma in the Guide > [/] index of asthma prediction index, children with positive asthma predictive index were enrolled in group I (50 cases), and children with negative asthma predictive index were enrolled in group II (53 cases). 54 cases of non infectious diseases such as surgical hernia and kidney stones in the same age group were randomly selected (28 men and 26 women). As a non infected control group, the average age of June -2 years was 1 years old in April, the average age was 1 years old in July. 50 children (25 men and 25 women) in our hospital were selected as the control group of bronchopneumonia in the same period. The age of 6 months to 2 years March and the average of 1 years in August were 1. There was no statistical significance (Pa0.05). All children were born in full term, excluding children with cancer, excluding children with airway malformation, no history of infection in the last 2 weeks, no history of use of immunomodulators, their parents informed consent and agreed with the hospital ethics committee.
The proportion of MDSCs in peripheral blood mononuclear cells was detected by flow cytometry, and the level of IL-10 and IL-12 in peripheral blood serum was detected by ELISA (enzyme-linked immunosorbent assay).
Statistical analysis was performed with SPSS17.0 statistical software. The data of each group were expressed as (x + S). The difference analysis between groups was analyzed by single factor analysis of variance, Bonferroni method was tested, and the correlation analysis was analyzed by Pearson linear correlation, and a=0.05 was used as a statistical test.
Result
1. compared with group II group, the level of serum IL-10 was significantly increased in peripheral blood and serum IL-12 level was significantly decreased (P0.05) in peripheral blood MDSCs%, compared with that in control group, MDSCs% in peripheral blood was significantly higher than that in control group, and serum IL-10 level was significantly increased, and serum IL-12 level decreased significantly (P0.05).
Compared with group II, the level of serum IL-10 and serum IL-12 were significantly higher in group 2. group I than in group II group, and serum IL-12 level was significantly decreased (P0.05). Compared with the control group, the peripheral blood MDSCs%, serum IL-10 level and serum IL-12 level were significantly decreased (P0.05) in the hair Branch II group compared with the control group.
3. compared with the hair branch I group, there was no significant difference in peripheral blood MDSCs%, serum IL-10 level and IL-12 level (P0.05) compared with the group I group (P0.05), and there was no significant difference between the peripheral blood MDSCs%, the serum IL-10 level and the serum IL-12 level in the panting group II group compared with the group II Group (P0.05).
4. there was no significant difference in peripheral blood MDSCs%, serum IL-10 level and IL-12 level between the pneumonia control group and the non infection control group (P0.05).
5. correlation analysis: there was a positive correlation between MDSCs% and serum IL-10 level in group I group I and group I, and negative correlation with serum IL-12 level. Group II, group II, pneumonia control group and non infected control group had no correlation with serum IL-10 level and serum IL-12 level.
conclusion
MDSCs may play an important role in the pathogenesis of bronchiolitis and recurrent wheezing by up regulating IL-10 level and downregulating IL-12 level.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R725.6

【参考文献】