Nylén O, Berg-Kelly K, Andersson B
Department of Pediatric Otorhinolaryngology and Head and Neck Surgery, East Hospital, Göteborg, Sweden.
Acta Paediatr. 2000 Nov;89(11):1322-5. doi: 10.1080/080352500300002507.
Epidemiological studies have demonstrated a prevalence of positive PPD reactions to non-tuberculous mycobacteria (NTM) in 9% of 4-5-y-old children in the Göteborg area. Very few children of this age develop suppurative infections in lymph nodes that require surgical procedures. The hypothesis was that these children might have T cell deficiencies with abnormalities of macrophage functions, particularly with type 1 cytokines. Twenty-four children who needed operations were investigated immunologically and compared to 10 children of the same age operated on for non-infectious reasons. The methods used were flow cytometry analysis of lymphocytes in blood, blood lymphocyte stimulation assays and interferon gamma analyses. The patients had significantly lower levels of interferon gamma than the controls after stimulation with Candida antigens or Con A. The numbers of T and B lymphocytes were higher in patients than in controls.
Children with necrotic lymph node infections in the cervical region due to NTM had lower interferon gamma production after stimulation than healthy age-matched controls.
流行病学研究表明,哥德堡地区4至5岁儿童中,对非结核分枝杆菌(NTM)的PPD反应阳性率为9%。这个年龄段很少有儿童发生需要手术治疗的淋巴结化脓性感染。假设是这些儿童可能存在T细胞缺陷以及巨噬细胞功能异常,尤其是1型细胞因子方面。对24名需要手术的儿童进行了免疫学调查,并与10名因非感染性原因接受手术的同龄儿童进行比较。所采用的方法包括血液中淋巴细胞的流式细胞术分析、血液淋巴细胞刺激试验和干扰素γ分析。在用念珠菌抗原或刀豆蛋白A刺激后,患者的干扰素γ水平显著低于对照组。患者的T淋巴细胞和B淋巴细胞数量高于对照组。
因NTM导致颈部坏死性淋巴结感染的儿童,刺激后产生的干扰素γ低于年龄匹配的健康对照组。