Pluzhnikov M S, Katinas E B, Riabova M A, Karpishchenko S A, Totolian A A
Vestn Otorinolaringol. 2008(4):57-61.
Clinical-immunological examination of 41 patients with recurrent respiratory papillomatosis (RRP) included determination of phenotype CD3, CD4, CD8, CD16, CD25, CD56, HLA-DR in peripheral blood by flow cytofluorimetry, the levels of IFN-gamma, TNF-alpha, GM-CSF, IL-2, IL-4, IL-5, IL-10, IL-12, IL-13 in the laryngeal secretion by multiplex immunoassay. Interferon inhalation therapy was conducted to prevent recurrence in 23 patients after surgical treatment and in 18 patients as monotherapy. The efficacy of the monotherapy was 45.5%. Treatment with IFN-alpha raised the levels of cytokines modulating an immune response by Th1-type (IFN-gamma, IL-12, IL-2) and GM-CSF, and reduced the levels of IL-4, IL-10 and IL-13. Local treatment with recombinant IFN-alpha is effective in aggressive RRP. As prognostic markers of the treatment efficacy may serve baseline high levels of TNF-alpha and IL-4/IFN-gamma index in laryngeal secretion. Treatment efficacy can be assessed by raise of IFN-gamma, IL-2 and IL-12 in combination with reduction of IL-4/IFN-gamma index.
对41例复发性呼吸道乳头状瘤病(RRP)患者进行临床免疫检查,包括通过流式细胞荧光术测定外周血中CD3、CD4、CD8、CD16、CD25、CD56、HLA - DR的表型,采用多重免疫测定法测定喉分泌物中IFN - γ、TNF - α、GM - CSF、IL - 2、IL - 4、IL - 5、IL - 10、IL - 12、IL - 13的水平。对23例手术治疗后的患者和18例患者采用干扰素吸入疗法预防复发,作为单一疗法。单一疗法的有效率为45.5%。使用α干扰素治疗可提高由Th1型调节免疫反应的细胞因子(IFN - γ、IL - 12、IL - 2)和GM - CSF的水平,并降低IL - 4、IL - 10和IL - 13的水平。局部使用重组α干扰素治疗侵袭性RRP有效。作为治疗效果的预后标志物,可能是喉分泌物中基线高水平的TNF - α和IL - 4/IFN - γ指数。治疗效果可通过IFN - γ、IL - 2和IL - 12升高以及IL - 4/IFN - γ指数降低来评估。