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黏膜免疫在支气管哮喘及变应性鼻炎发病中的作用
李风森,徐丹,杜丽娟
0
(新疆医科大学附属中医医院,国家中医临床研究基地,乌鲁木齐 830000)
摘要:
\[摘要\]目的探讨黏膜免疫在哮喘、变应性鼻炎发病过程中的作用,寻找两种病发病时共同的联系物质,以揭示哮喘与变应性鼻炎发病之间的关联性。方法收集急性发作期哮喘患者82例(其中单纯哮喘44例,哮喘合并鼻炎38例),单纯变应性鼻炎患者30例,正常对照组30例。分别采集受检者唾液、痰液、鼻腔分泌物各2 ml,用ELISA法测定分泌型免疫球蛋白A(sIgA)的变化。采肘静脉血各2 ml,用流式细胞仪检测CD4+、CD8+淋巴细胞,荧光酶联免疫法检测血清嗜酸性阳离子蛋白(eosinophil cationic protein,ECP)、总免疫球蛋白E(total immunoglobulin E,T-IgE)。结果痰液中sIgA含量在单纯哮喘组、哮喘合并鼻炎组、单纯变应性鼻炎组均较正常组降低(P<0.01);唾液sIgA含量在哮喘组、合并组较正常组有降低趋势但差异无统计学意义。鼻腔分泌物中sIgA各组比较,哮喘组与合并组均高于正常组(P<0.05)及鼻炎组(P<0.01),而鼻炎组与正常组之间差异无统计学意义。血液中CD4+细胞在哮喘组、合并组均高于正常组(P<0.05);血液中CD8+细胞在各组间差异无统计学意义;CD4+/CD8+在哮喘组较正常组和鼻炎组增高(P<0.05)。血清T-IgE在合并组及鼻炎组均较正常组增高(P<0.01)。正常组血清ECP检出率极低;哮喘组血清ECP高于鼻炎组(P<0.05),而哮喘组与合并组、鼻炎组与合并组差异无统计学意义。哮喘组ECP与T-IgE正相关(r=0.467,P<0.05),合并组与鼻炎组ECP与T-IgE无相关性。结论哮喘和变应性鼻炎都与黏膜免疫有密切关系,黏膜免疫可能是其发病过程中相同的病理特征在不同部位的体现。而sIgA、CD4+、CD8+、ECP、T-IgE等免疫介质可能是黏膜免疫的物质基础之一。
关键词:  哮喘  变应性鼻炎  黏膜免疫  相互关联
DOI:10.3724/SP.J.1008.2011.0182
投稿时间:2010-09-07修订日期:2011-01-18
基金项目:国家自然科学基金(30860355),新疆自然科学基金(2009211A21).
Role of mucosal immunity in pathogenesis of asthma and allergic rhinitis
LI Feng-sen,XU Dan, DU Li-juan
(Traditional Chinese Medicine Hospital, Xinjiang Medical University, State Research Center of Traditional Chinese Medicine, Urumuchi 830000, Xinjiang, China)
Abstract:
\[Abstract\]ObjectiveTo explore the role of mucosal immunity in the pathogenesis of asthma and allergic rhinitis and to search for common materials for the two conditions, so as to reveal the relationship of asthma and allergic rhinitis. MethodsA total of 82 patients with acute asthma, including 44 with asthma alone and 38 with asthma complicated with rhinitis, were included in this study. Another 30 patients with allergic rhinitis alone and 30 healthy controls were also included. The saliva, sputum, and nasal secretions (all 2 ml) were collected to observe the secretory immunoglobulin-A(sIgA) by enzyme-linked immunosorbent assay(ELISA). Flow cytometry was employed to observe CD4+, CD8 + lymphocytes in blood samples (2 ml) obtained from the elbow vein. The levels of eosinophil cationic protein(ECP) and serum total immunoglobulin E(T-IgE) were assessed by fluorescent enzyme immunoassay. ResultsSputum sIgA levels in the asthmatic group, combination group, and rhinitis group were significantly lower than that in the normal control group (P<0.01) ; saliva sIgA levels in the asthmatic group and combination group had a decreasing tendency but had no significant difference compared with that in the normal control group. sIgA levels in the nasal secretions in the asthma group and combination group were significantly higher than those in the normal control group (P<0.05) and rhinitis group (P<0.01), and there was no significant difference between the rhinitis group and the control group. Blood CD4+ cells in the asthmatic group and combination group were decreased than that in the normal control group (P<0.05). Blood CD8+ cells were similar in all the groups. CD4+/CD8+ cells in the asthma group was significantly more than those in the normal control group and rhinitis group (P<0.05). Serum T-IgE-levels in the combination group and rhinitis group were significantly higher than that in the normal control group (P<0.01). Serum ECP was hardly detected in the normal control group; that in the asthma group was significantly higher than that in the rhinitis group (P<0.05), and that in the combined group was not significantly different with those in the asthma group or the rhinitis group. ECP and T-IgE levels were positively correlated (r=0.467, P<0.05) in the asthma group, and not correlated in other groups. ConclusionThe asthma and allergic rhinitis are both closely related to mucosal immunity, which is the manifestation of asthma and rhinitis in different sites. The sIgA, CD4+, CD8+, ECP, and T-IgE may be the material bas for mucosal immunity.
Key words:  asthma  allergic rhinitis  mucosal immunity  correlation