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[尘螨变应原特异性免疫治疗对哮喘儿童预后的影响]

[Effects of Dermatophagoides pteronyssinus allergen-specific immunotherapy on the prognosis of asthmatic children].

作者信息

Chen Zhuang-Gui, Chen Yan-Feng, Li Ming, Ji Jing-Zhi, Chen Fen-Hua, Chen Hong

机构信息

Department of Pediatrics, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.

出版信息

Nan Fang Yi Ke Da Xue Xue Bao. 2009 Jun;29(6):1179-81.

PMID:19726355
Abstract

OBJECTIVE

To investigate the effects of Dermatophagoides pteronyssinus allergen-specific immunotherapy (SIT) on the prognosis of asthmatic children.

METHODS

Sixty-five children with established diagnosis of allergic asthma to dust mite were enrolled in this study, of whom 42 children received treatment with standardized SIT for 12 month and the other 23 served as the control group with inhaled corticosteroids according to Global Initiative for Asthma (GINA). The serum levels of interleukin-4 (IL-4) and interferon-gamma (IFN-gamma) were detected and the pulmonary functions examined before and after the one-year treatment in all the patients.

RESULTS

After the one-year treatment with SIT, the asthmatic children showed obviously reduced serum levels of IL-4, significantly increased IFN-gamma levels and the IFN-gamma/IL-4 ratio (P<0.05), and markedly improved pulmonary functions (FVC, pre-FEV1% and pre-PEF%) (P<0.05). In the control group, the children exhibited significantly increased IFN-gamma levels and IFN-gamma/ IL-4 ratio (P<0.05) without obvious reduction of serum IL-4 levels or pulmonary function improvement (P>0.05). With comparable basic pulmonary functions in the two groups before the treatment, the children in SIT group showed significantly greater improvement in the pulmonary functions than those in the control group after the one-year treatment.

CONCLUSION

The one-year treatment with SIT can significantly improve the pulmonary functions of children with allergic asthma, and this effect is attributed to the regulation of Th1/Th2 cell balance and inhibition of asthmatic airway remodeling by SIT.

摘要

目的

探讨尘螨变应原特异性免疫疗法(SIT)对哮喘儿童预后的影响。

方法

本研究纳入65例确诊为尘螨过敏性哮喘的儿童,其中42例儿童接受标准化SIT治疗12个月,另外23例作为对照组,根据全球哮喘防治创议(GINA)使用吸入性糖皮质激素。检测所有患者治疗前及治疗1年后的血清白细胞介素-4(IL-4)和干扰素-γ(IFN-γ)水平,并检查肺功能。

结果

SIT治疗1年后,哮喘儿童血清IL-4水平明显降低,IFN-γ水平及IFN-γ/IL-4比值显著升高(P<0.05),肺功能(FVC、FEV1%预计值和PEF%预计值)明显改善(P<0.05)。对照组儿童IFN-γ水平及IFN-γ/IL-4比值显著升高(P<0.05),血清IL-4水平无明显降低,肺功能无改善(P>0.05)。两组治疗前基础肺功能相当,SIT组儿童治疗1年后肺功能改善程度明显大于对照组。

结论

SIT治疗1年可显著改善过敏性哮喘儿童的肺功能,这一作用归因于SIT对Th1/Th2细胞平衡的调节及对哮喘气道重塑的抑制。

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