Zhu Ya-Fei, Cai Xiao-Hong, Zhu Jian-Yang, Jiang Wei-Ping, Lan Ju-Hong, Liu Sheng
Department of Pediatrics, Lishui Municipal Central Hospital, Lishui 323000, China.
Zhonghua Yi Xue Za Zhi. 2009 Jun 9;89(22):1563-6.
To explore the pathogenesis of respiratory syncytial viruses (RSV) bronchiolitis and its treatment with glucocorticoids.
The pediatric patients with RSV bronchiolitis were divided into an atopic group (n = 50) and a non-atopic group (n = 50) based on whether there were IgE elevation, eczema and dermatitis. Another 25 normal subjects were chosen as a control group. Divided into mild, medium and severe groups, they were finally randomly divided into hormone (dexamethasone) and non-hormone groups. The proportion of CD4+ CD25+ regulatory T cells (Treg) and the expression of Foxp3 mRNA were tested by flow cytometry and RT-PCR retrospectively.
The proportion of CD4+ CD25+ Treg and the Foxp3 mRNA expression in the control, non-atopic, and atopic groups reached (10.5 +/- 1.6)% and 0.34 +/- 0.11, (8.8 +/- 2.2)% and 0.26 +/- 0.08, (7.6 +/- 1.8)% and 0.21 +/- 0.09, respectively. There were significant differences among these groups (all P < 0.05). The mild, medium and severe bronchiolitis groups reached (9.7 +/- 1.6)% and 0.28 +/- 0.08, (7.8 +/- 2.1)% and 0.24 +/- 0.06, (6.7 +/- 1.3)% and 0.20 +/- 0.07 respectively (all P < 0.05). The proportion of CD4+ CD25+ Treg and the expression of Foxp3 showed significantly negative correlations with severity (r = -0.62, -0.71, both P < 0.01). That is, they correlated with the severity of disease. The proportion of the CD4+ CD25+ Treg and the expression of Foxp3 mRNA of the hormone group were higher than those of the non-hormone group [(9.5 +/- 2.1)% and 0.33 +/- 0.10 vs (8.5 +/- 1.8)% and 0.27 +/- 0.12, P < 0.05 and < 0.01] respectively.
CD4+ CD25+ Treg and Foxp3 mRNA are involved in the inflammation of bronchiolitis. And the levels of CD4+ CD25+ Treg and Foxp3 mRNA level is an objective indicator of the severity of RSV bronchiolitis. The effect of glucocorticoids upon RSV bronchiolitis may be in part due to the direct enhancement of production and functions of CD4+ CD25+ Treg and Foxp3 mRNA.
探讨呼吸道合胞病毒（RSV）毛细支气管炎的发病机制及其糖皮质激素治疗。
根据是否存在IgE升高、湿疹和皮炎，将RSV毛细支气管炎患儿分为特应性组（n = 50）和非特应性组（n = 50）。另选25名正常受试者作为对照组。根据病情分为轻、中、重度组，最终随机分为激素（地塞米松）组和非激素组。采用流式细胞术和RT-PCR回顾性检测CD4+ CD25+调节性T细胞（Treg）比例及Foxp3 mRNA表达。
对照组、非特应性组和特应性组CD4+ CD25+ Treg比例及Foxp3 mRNA表达分别为（10.5±1.6）%和0.34±0.11、（8.8±2.2）%和0.26±0.08、（7.6±1.8）%和0.21±0.09。各组间差异有统计学意义（均P < 0.05）。轻度、中度和重度毛细支气管炎组分别为（9.7±1.6）%和0.28±0.08、（7.8±2.1）%和0.24±0.06、（6.7±1.3）%和0.20±0.07（均P < 0.05）。CD4+ CD25+ Treg比例及Foxp3表达与病情严重程度呈显著负相关（r = -0.62、-0.71，均P < 0.01）。即与疾病严重程度相关。激素组CD4+ CD25+ Treg比例及Foxp3 mRNA表达高于非激素组[（9.5±2.1）%和0.33±0.10 对比（8.5±1.8）%和0.27±0.12，P < 0.05和< 0.01]。
CD4+ CD25+ Treg和Foxp3 mRNA参与毛细支气管炎炎症反应。CD4+ CD25+ Treg水平及Foxp3 mRNA水平是RSV毛细支气管炎严重程度的客观指标。糖皮质激素对RSV毛细支气管炎的作用可能部分归因于直接增强CD4+ CD25+ Treg的产生及功能和Foxp3 mRNA。
