Prescott S L, Taylor A, King B, Dunstan J, Upham J W, Thornton C A, Holt P G
Department of Paediatrics, Division of Clinical Sciences and Division of Cell Biology, School of Paediatrics and Child Health Research, University of Western Australia, and Princess Margaret Hospital, Perth, Australia.
Clin Exp Allergy. 2003 May;33(5):566-72. doi: 10.1046/j.1365-2222.2003.01659.x.
A reduced capacity of antigen presenting cells (APC) to provide pro-T helper 1 (Th1) signals, such as IL-12, to T cells during early life may be implicated in the development of T helper 2 (Th2)-mediated allergic disease. In this study we examined the relationships between the capacity for IL-12 responses in the neonatal period and atopic risk (family allergy), in vitro T cell responses to allergens, and the subsequent development of allergic disease at 6 years.
The capacity of circulating neonatal (and maternal) APC to produce IL-12 p70 in response to LPS (and IFN-gamma) stimulation was assessed in a group of 60 children with previously well-characterized immune responses to allergens and atopic outcomes. The IL-12 responses were compared with allergen-induced lymphoproliferation (to house dust mite (HDM) ovalbumin (OVA), cat and beta-lactoglobulin (BLG)) and IL-13 and IFN-gamma cytokine responses (to OVA, HDM and phytohaemaglutinin (PHA)) in the neonatal and postnatal periods. IL-12 responses were also compared according to atopic risk and atopic outcomes (doctor-diagnosed asthma, eczema, food allergies and sensitization as evidenced by skin prick testing) at 6 years clinical follow-up.
Maternal peripheral blood mononuclear cells (PBMC) synthesized significantly greater amounts of IL-12 than neonatal PBMC, though within maternal-infant pairs IL-12 responses were significantly correlated (r = 0.4, P = 0.019). Moreover, neonatal IL-12 responses were positively correlated with neonatal allergen proliferation for HDM (r = 0.6, P < 0.0001), OVA (r = 0.55, P < 0.0001), cat (r = 0.5, P = 0.003) and BLG (r = 0.55, P = 0.001), but negatively correlated with neonatal IL-13 responses to both allergens tested (HDM: r = - 0.4, P = 0.03 and OVA: r = - 0.5, P = 0.001). Both neonatal and maternal IL-12 responses were positively correlated with postnatal IFN-gamma responses to HDM at 12, 18 and 24 months of age (responses after age of 2 years were not assessed). There was no relationship between atopic risk and IL-12 capacity in the neonatal period, but there was a (non-significant) trend for neonatal IL-12 responses to be lower in the high-risk children who developed clinical allergy at 6 years (compared with the low risk group) although the number in this analysis was small.
Reduced APC IL-12 production in the perinatal period was associated with reduced T cell activation (lymphoproliferation), stronger neonatal Th2 responses, and weaker Th1 responses to allergen in the postnatal period. This supports the notion that variations in APC function in early life may contribute to altered allergen-specific cytokine responses associated with later allergy.
在生命早期,抗原呈递细胞(APC)向T细胞提供促辅助性T细胞1(Th1)信号(如白细胞介素-12(IL-12))的能力降低,可能与辅助性T细胞2(Th2)介导的过敏性疾病的发生有关。在本研究中,我们探讨了新生儿期IL-12反应能力与特应性风险(家族过敏)、体外T细胞对过敏原的反应以及6岁时过敏性疾病后续发展之间的关系。
在一组60名对过敏原具有明确免疫反应和特应性结局的儿童中,评估循环新生儿(及母亲)APC对脂多糖(LPS)(及干扰素-γ)刺激产生IL-12 p70的能力。将IL-12反应与新生儿期和出生后期过敏原诱导的淋巴细胞增殖(对屋尘螨(HDM)、卵清蛋白(OVA)、猫和β-乳球蛋白(BLG))以及IL-13和干扰素-γ细胞因子反应(对OVA、HDM和植物血凝素(PHA))进行比较。在6年临床随访时,还根据特应性风险和特应性结局(医生诊断的哮喘、湿疹、食物过敏以及皮肤点刺试验证实的致敏)比较IL-12反应。
母亲外周血单个核细胞(PBMC)合成的IL-12量显著多于新生儿PBMC,不过在母婴配对中,IL-12反应显著相关(r = 0.4,P = 0.019)。此外,新生儿IL-12反应与HDM(r = 0.6,P < 0.0001)、OVA(r = 0.55,P < 0.0001)、猫(r = 0.5,P = 0.003)和BLG(r = 0.55,P = 0.001)的新生儿过敏原增殖呈正相关,但与所检测的两种过敏原(HDM:r = - 0.4,P = 0.03;OVA:r = - 0.5,P = 0.001)的新生儿IL-13反应呈负相关。新生儿和母亲的IL-12反应均与12、18和24月龄时对HDM的出生后干扰素-γ反应呈正相关(未评估2岁以后的反应)。新生儿期特应性风险与IL-12能力之间无关联,但在6岁时发生临床过敏的高危儿童中(与低风险组相比),新生儿IL-12反应有(不显著的)降低趋势,尽管该分析中的人数较少。
围产期APC产生IL-12减少与T细胞活化降低(淋巴细胞增殖)、更强的新生儿Th2反应以及出生后期对过敏原的Th1反应减弱有关。这支持了早期生命中APC功能的变化可能导致与后期过敏相关的过敏原特异性细胞因子反应改变的观点。