Noma T, Mori A, Yoshizawa I
Department of Pediatrics, Saitama Medical School, Japan.
J Allergy Clin Immunol. 1996 Oct;98(4):816-26. doi: 10.1016/s0091-6749(96)70131-8.
In pediatric patients with bronchial asthma and/or atopic dermatitis, peripheral lymphocytes are activated if they are stimulated with the responsible antigen, resulting in induction of responsiveness to IL-2. Because some nursing infants experience recurrent wheezing after respiratory syncytial virus (RSV) infection, attention is being directed to progression of the disease to bronchial asthma.
The study was designed to elucidate the mechanism of the onset of allergic diseases after RSV infection.
We examined allergen-specific IL-2 responsiveness induced in lymphocytes in the peripheral blood of infants after infection by RSV. The relationship between the onset of recurrent wheezing and antigen-specific IL-2 responsiveness was analyzed in 25 pediatric patients who could be followed up for 3 years after RSV infection.
Stimulation of lymphocytes with ovalbumin, alpha-casein, and mite (Dermatophagoides farinae) antigens induced significantly higher responsiveness to IL-2 in the RSV-infected infant group than in the healthy infant and disease control groups of the same age. There was no clear correlation between the IgE RAST scores for D. farinae, ovalbumin, and alpha-casein and IL-2 responsiveness. The families of RSV-infected infants had a high incidence of history of allergy (67%), but there was no significant difference in the incidence of patients with positive test results for IL-2 responsiveness between the groups with and without a familial history of allergy. The D. farinae-specific IL-2 responsiveness was significantly increased in the group with the symptom (16 patients) for a value of 1.64 +/- 0.13 (mean +/- SEM) compared with the value of 1.31 +/- 0.21 in the asymptomatic group (9 patients). The incidence of patients with positive test results for IL-2 responsiveness was 68.8% in the symptomatic group and 44.4% in the asymptomatic group. Similarly, the ovalbumin-specific IL-2 responsiveness was significantly increased in the symptomatic group (1.63 +/- 0.17) compared with the asymptomatic group (1.12 +/- 0.26). The incidence of patients with positive test results was 62.5% and 22.2%, respectively. alpha-Casein-specific IL-2 responsiveness was also higher in the symptomatic group than in the asymptomatic group, but the difference was not statistically significant. In the patient groups without RSV infection, on the other hand, the D. farinae-, ovalbumin-, and alpha-casein-specific IL-2 responsiveness in the symptomatic group were all similar to that in the asymptomatic group; no significant increases were detected.
The results indicated that after RSV infection, lymphocytes acquire specific susceptibility to D. farinae, a mite antigen, and food antigens, particularly ovalbumin. Hence, it is thought that positive IL-2 responsiveness specific for D. farinae and/or ovalbumin, detected several months after RSV infection, can be a prediction factor for the onset of allergic diseases, such as recurrent wheezing and bronchial asthma.
在患有支气管哮喘和/或特应性皮炎的儿科患者中，如果用相关抗原刺激外周淋巴细胞，这些细胞会被激活，从而导致对白细胞介素-2（IL-2）反应性的诱导。由于一些哺乳婴儿在呼吸道合胞病毒（RSV）感染后会反复喘息，因此人们开始关注该疾病向支气管哮喘的进展。
本研究旨在阐明RSV感染后过敏性疾病发病的机制。
我们检测了RSV感染后婴儿外周血淋巴细胞中诱导的过敏原特异性IL-2反应性。分析了25例RSV感染后可随访3年的儿科患者中反复喘息发作与抗原特异性IL-2反应性之间的关系。
用卵清蛋白、α-酪蛋白和螨（粉尘螨）抗原刺激淋巴细胞后，RSV感染婴儿组对IL-2的反应性明显高于同龄健康婴儿和疾病对照组。粉尘螨、卵清蛋白和α-酪蛋白的IgE RAST评分与IL-2反应性之间没有明显的相关性。RSV感染婴儿的家族过敏史发生率较高（67%），但有家族过敏史组和无家族过敏史组中IL-2反应性检测结果为阳性的患者发生率没有显著差异。有症状组（16例患者）的粉尘螨特异性IL-2反应性显著升高，为1.64±0.13（平均值±标准误），而无症状组（9例患者）的值为1.31±0.21。有症状组中IL-2反应性检测结果为阳性的患者发生率为68.8%，无症状组为44.4%。同样，有症状组（1.63±0.17）的卵清蛋白特异性IL-2反应性明显高于无症状组（1.12±0.26）。检测结果为阳性的患者发生率分别为62.5%和22.2%。α-酪蛋白特异性IL-2反应性在有症状组中也高于无症状组，但差异无统计学意义。另一方面，在未感染RSV的患者组中，有症状组的粉尘螨、卵清蛋白和α-酪蛋白特异性IL-2反应性均与无症状组相似；未检测到显著升高。
结果表明，RSV感染后，淋巴细胞对螨抗原粉尘螨和食物抗原（特别是卵清蛋白）获得了特异性易感性。因此，人们认为在RSV感染数月后检测到的针对粉尘螨和/或卵清蛋白的阳性IL-2反应性可能是反复喘息和支气管哮喘等过敏性疾病发病的预测因素。
