摘要
目的探讨生长因子β1在儿童哮喘中的作用及观察孟鲁司特钠对其的影响。方法筛选2009年9月-2010年9月我院哮喘专病门诊轻度持续哮喘患儿60例及来院健康体检儿童30例,将哮喘患儿随机分成孟鲁司特钠组和安慰剂对照组;采用双抗夹心酶联免疫吸附试验(ELISA)、RT-PCR技术分别检测治疗前后患儿血浆中TGF-β1水平和外周血单个核细胞(PBMC)中TGF-β1mRNA表达;采用流式细胞技术,检测表达叉状头/翅膀状螺旋转录因子3的CD4T调节细胞(Foxp3 CD4+Treg)及各亚型的比例。结果(1)血浆中TGF-β1水平:治疗前哮喘组[(11.51β1.12)ng/L]明显低于健康对照组[(47.92±1.52)ng/L](q=20.01,P〈0.01);治疗后,孟鲁司特钠组[(20.03±1.14)ng/L]高于安慰剂组[(12.10±3.91)ng/L](q=14.62,P〈0.05),但均值仍低于健康对照组;(2)外周血单个核细胞中TGF—β1mRNA表达:治疗前哮喘组(0.31±0.07)明显低于健康对照组(0.61±0.2)(q=8.97,P〈0.05);治疗后,孟鲁司特钠组(0.46±0.13)表达高于安慰剂组(0.32±0.04)(q=8.25,P〈0.05),但仍低于健康对照组;(3)流式细胞检测结果各组间比较差异有统计学意义(P〈0.05):哮喘患儿与健康对照组相比,Foxp,CD4Treg细胞比例增加[(8.30±1.30)%,(6.05±1.80)%];其中cD45RAFoxp3“比例增高[(4.60±1.04)%,(3.27±1.03)%];CD45RA—Foxp3“比例降低[(0.75±0.13)%,(0.93±0.26)%];CD45RA—Foxp3比例两组差异无统计学意义。治疗后,孟鲁司特钠组较安慰剂组,aTreg细胞占Foxp,CD+Treg比例增加[(1.16±0.24)%,(0.89±0.22)%],差异有统计学意义。结论哮喘儿童体内存在血浆及外周血单个核细胞中TGF—β1表达的降低,可能是导致哮喘发病的重要原因;孟鲁司特钠能有�
Objective To investigate the role of transforming growth factor betal (TGF-beta1 ) in the pathogenesis of bronchial asthma in children and assess the effect of montelukast sodium (leukotriene receptor antagonist) on TGF-beta1 levels. Method A 12 weeks single-blind, placebo-controlled trail was conducted in 60 children with mild persistent asthma [ aged 5-14 years, mean ( 7. 10 ± 0.27 ) years ]. Patients were randomly assigned to receive 5 mg montelukast sodium or placebo for 12 weeks. And 30 heathly control children [ aged 5-14 years, mean ( 7.60±0.25 ) years ] were also recruited in this study from Sep. 2009 to Sep. 2010. Clinical effects and pulmonary function were evaluated before and 12 weeks after treatment. The mRNA expression of TGF-beta1 in the peripheral blood mononuclear cells was detected by using RT-PCR with beta-actin as internal control. The percentage of the different subpopulations of Foxp3 + CD4 + T cells was assayed by 4-color flow cytometric analysis system and the levels of TGF-betaI in plasma by ELISA. Result ( 1 ) The basic characteristics between asthma group and healthy group had no significant difference. (2) Following treatment, there was significant increase in pulmonary function in asthmatic children. The effect in the group of montelukast sodium was superior to that of placebo group ( P 〈 0.05). (3) The serum expression of TGF-beta in asthmatic children was lower than that in control group (q =20. 01 ,P 〈0. 01 ) ;after 12 weeks of treatment, the mean expression of TGF-beta1 was (20.03 ± 1.14) ng/L for montelukast sodium group and ( 12.10 ± 3.91 ) ng/L for placebo group ( P 〈 0.05 ). (4) The mRNA expression of TGF-betal in asthma children was lower than that in control group (0.31 ±0.07 vs 0. 61 ± 0. 2, q = 8.97,P 〈 0.05); after 12 weeks of treatment, the mean expression of TGF-beta1 was (0.46 ±0. 13 ) for montelukast sodium group and (0.32 ± 0.04) for placebo group ( q = 8.25, P 〈 0.05 ). (5)
出处
《中华儿科杂志》
CAS
CSCD
北大核心
2011年第9期679-684,共6页
Chinese Journal of Pediatrics