摘要
目的探讨肺炎支原体肺炎(Mycoplasma pneumoniae pneumonia,MPP)中白细胞介素(interleukin,IL)-4/IL-13信号通路对辅助型T细胞2(T helper 2 cell,Th2)分化及气道炎症的影响。方法采用回顾性研究方法,选择2022年1月至2023年1月在首都医科大学附属北京朝阳医院怀柔医院住院的45例MPP患儿(其中轻度MPP组23例,重度MPP组22例)和18例异物吸入患儿(对照组)作为研究对象。收集支气管肺泡灌洗液(bronchoalveolar lavage fluid,BALF),使用人类细胞因子/趋化因子磁珠板试剂盒测定BALF中肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、单核细胞趋化蛋白1(monocyte chemotactic protein 1,MCP1)、IL-6、IL-1β、IL-4、IL-10、IL-13、IL-5、IL-2、γ-干扰素(interferon-γ,IFN-γ)水平。统计学方法采用单因素方差分析、LSD-t检验、χ^(2)检验、Fisher确切概率法和线性判别分析。结果重度MPP组患儿的C反应蛋白(C-reactive protein,CRP)、中性粒细胞百分比均高于轻度MPP组,差异均有统计学意义(P值均<0.05)。轻度MPP组患儿BALF中TNF-α、IL-6、IL-1β、MCP1、IL-4、IL-10和IFN-γ水平均高于对照组,重度MPP组患儿BALF中TNF-α、IL-6、IL-1β、MCP1、IL-4、IL-10和IFN-γ水平均高于轻度MPP组;轻度和重度MPP组患儿中IL-13和IL-5水平均高于对照组,差异均有统计学意义(P值均<0.05)。线性判别分析结果显示,基于细胞因子分组法可以正确识别88.9%的对照组、78.3%的轻度MPP组和86.4%的重度MPP组。轻度、重度MPP组和对照组患儿中的IFN-γ/IL-4比值(3.10±1.75、2.43±1.70与0.97±0.48)、IFN-γ/IL-13比值(2.78±1.95、3.47±2.68与1.00±0.56)显示,轻度和重度MPP组显著高于对照组,差异均有统计学意义(P值均<0.05)。结论轻度MPP和重度MPP的特征是Th1相关细胞因子(IFN-γ)的增加高于Th2相关细胞因子(IL-4和IL-13)的增加,导致BALF炎症增加。
Objective To investigate the effect of interleukin(IL)-4/IL-13 signaling pathway on the differentiation of T helper 2 cell(Th2)and airway inflammation in Mycoplasma pneumoniae pneumonia(MPP).Method This retrospective study selected 45 children with MPP(including 23 cases in mild MPP group and 22 cases in severe MPP group)and 18 children with foreign body inhalation(control group)who were hospitalized in Huairou Hospital,Beijing Chaoyang Hospital,Capital Medical University from January 2022 to January 2023 as research objects.Bronchoalveolar lavage fluid(BALF)was collected,and tumor necrosis factor-α(TNF-α),monocyte chemotactic protein 1(MCP1),IL-6,IL-1β,IL-4,IL-10,IL-13,IL-5,IL-2,interferon-γ(IFN-γ)levels in BALF was determined using the human cytokine/chemokine magnetic bead kit.Statistical methods performed by One-way ANOVA analysis,LSD-t test,χ^(2) test,Fisher exact probability method and discriminant analysis.Result The C-reactive protein(CRP)and neutrophil percentage in the severe MPP group were higher than those in the mild MPP group,and the differences were statistically significant(all P<0.05).The levels of TNF-α,IL-6,IL-1β,MCP1,IL-4,IL-10 and IFN-γin BALF in mild MPP group were higher than those in control group.The levels of TNF-α,IL-6,IL-1β,MCP1,IL-4,IL-10 and IFN-γin BALF in severe MPP group were higher than those in mild MPP group.The levels of IL-13 and IL-5 in mild MPP group and severe MPP group were higher than those in control group,and the differences were statistically significant(all P<0.05).The results of discriminant analysis showed that 88.9%of the control group,78.3%of the mild MPP group and 86.4%of the severe MPP group could be correctly identified by the cytokine grouping method.The IFN-γ/IL-4 ratios(3.10±1.75,2.43±1.70 vs 0.97±0.48)and IFN-γ/IL-13 ratios(2.78±1.95,3.47±2.68 vs 1.00±0.56)in mild and severe MPP groups and control groups showed that the ratios of mild and severe MPP groups were significantly higher than the control group,and the differences were statistically significant(all P<0.05).Conclusion Mild MPP and severe MPP are characterized by the increase of Th1-related cytokines(IFN-γ)higher than that of Th2-related cytokines(IL-4 and IL-13),which leads to the increase of BALF inflammation.
作者
孙晓磊
王国伟
周滨
杨欢
王玉
Sun Xiaolei;Wang Guowei;Zhou Bin;Yang Huan;Wang Yu(Department of Pediatrics,Huairou Hospital,Beijing Chaoyang Hospital,Capital Medical University,Beijing 101400,China)
出处
《发育医学电子杂志》
2025年第1期26-32,共7页
Journal of Developmental Medicine (Electronic Version)
基金
北京市卫生健康委员会科研项目(2022B265)。
关键词
肺炎支原体肺炎
细胞因子
支气管肺泡灌洗液
儿童
Th2细胞分化
Mycoplasma pneumoniae pneumonia
Cytokines
Bronchoalveolar lavage fluid
Children
Th2 cell differentiation
作者简介
通信作者:孙晓磊(Email:liuyanfu19890719@163.com)。
