支原体肺炎患儿血清白细胞介素-4,白细胞介素-17,干扰素-γ,白细胞介素-36的表达及临床意义
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摘要
目的探讨支原体肺炎(MPP)患儿血清细胞因子白细胞介素-4(IL-4),白细胞介素-17(IL-17),干扰素-γ(INF-γ),白细胞介素-36(IL-36)的表达及其临床意义。方法选择2011年11月1日至2015年11月1日在常州市金坛区人民医院住院的45例确诊为MPP患儿作为MPP组,并选择同期住院的19例行腹股沟疝手术患儿作为对照组进行前瞻性研究。支原体的诊断主要依据痰支原体DNA阳性及血清学指标。采用酶联免疫吸附测定法(ELISA)检测患儿血清中的IL-4、IL-17、IL-36、INF-γ的含量及变化。结果 MPP组血清IL-4、IL-17、IL-36及INF-γ水平在急性期为:[(723±263)、(398±218)、(413±291)、(3 144±1932)] ng/L;而对照组为:[(481±198)、(212±39)、(302±87)、(1 632±917)] ng/L,可见MPP组较对照组均明显增高(均P<0. 05),在恢复期下降,且大叶性肺炎,> 3岁年龄组MPP患儿这四个细胞因子水平均明显增高(均P <0. 05)。结论 MPP发生发展与IL-4、IL-17、IL-36及INF-γ密切相关,故检测这些细胞因子对病情评估有一定指导意义,有助于进一步指导MPP的临床治疗。
Objective To explore the serum levels and clinical significance of interleukin-4(IL-4),interleukin-17(IL-17),interferon-γ(INF-γ) and interleukin-36(IL-36) in children with mycoplasma pneumoniae pneumonia(MPP). Methods In the prospective study,serum levels of IL-4,IL-17,INF-γ and IL-36 were detected by enzyme-linked immunosorbent assay(ELISA) in 45 MPP patients hospitalized in Jintan District People's Hospital of Changzhou from November 2011 to November 2015. At the same time,serum levels of these cytokines of 19 controls hospitalized for surgery were also tested as controls. Diagnosis of mycoplasma pneumoniae was based on both DNA-PCR and serology. Results In acute stage,serum levels of IL-4,IL-17,IL-36 and INF-γ were(723 ± 263),(398 ± 218),(413 ± 291),(3 144 ± 1 932) ng/L in MPP patients,but in the control group were(481 ± 198),(212 ± 39),(302 ± 87),(1632 ±917) ng/L. So in acute stage,serum levels of IL-4,IL-17,INF-γ and IL-36 were higher in MPP patients and decreased in the convalescence stage(P < 0. 05). Moreover,patients diagnosed as lobar pneumonia,and aged > 3 years had higher levels of these cytokines.Conclusions IL-4,IL-17,INF-γ and IL-36 are involved in the development of MPP and have great clinical significance of disease evaluation.
Objective To explore the serum levels and clinical significance of interleukin-4(IL-4),interleukin-17(IL-17),interferon-γ(INF-γ) and interleukin-36(IL-36) in children with mycoplasma pneumoniae pneumonia(MPP). Methods In the prospective study,serum levels of IL-4,IL-17,INF-γ and IL-36 were detected by enzyme-linked immunosorbent assay(ELISA) in 45 MPP patients hospitalized in Jintan District People's Hospital of Changzhou from November 2011 to November 2015. At the same time,serum levels of these cytokines of 19 controls hospitalized for surgery were also tested as controls. Diagnosis of mycoplasma pneumoniae was based on both DNA-PCR and serology. Results In acute stage,serum levels of IL-4,IL-17,IL-36 and INF-γ were(723 ± 263),(398 ± 218),(413 ± 291),(3 144 ± 1 932) ng/L in MPP patients,but in the control group were(481 ± 198),(212 ± 39),(302 ± 87),(1632 ±917) ng/L. So in acute stage,serum levels of IL-4,IL-17,INF-γ and IL-36 were higher in MPP patients and decreased in the convalescence stage(P < 0. 05). Moreover,patients diagnosed as lobar pneumonia,and aged > 3 years had higher levels of these cytokines.Conclusions IL-4,IL-17,INF-γ and IL-36 are involved in the development of MPP and have great clinical significance of disease evaluation.
引文
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[6]刘贺临,王立锁,郑申建,等.白细胞介素2和白细胞介素6在支原体肺炎患儿血清及诱导痰中表达及临床意义研究[J].中国实用儿科杂志,2011,26(8):592-595.
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[9]王冬梅,姜采荣,王茹,等.肺炎支原体肺炎患儿血清白介素-23/白介素-17的表达[J].临床儿科杂志,2013,31(10):933-936.
[10]张群威,任志宏,程力平,等.肺炎支原体肺炎患儿外周血IL-10/IL-17表达与肺功能变化的相关性[J].安徽医药,2016,20(4):762-763.
[11] GABAY C,TOWNE JE. Regulation and function of interleukin-36cytokines in homeostasis and pathological conditions[J]. J Leukoc Biol,2015,97(4):645-652.
[12]张德凤,张彦萍,潘家华,等.儿童肺炎支原体肺炎143例临床分析[J].安徽医药,2013,17(7):1159-1162.
[13]左慧敏,刘秀云,江载芳.白介素8白介素10及γ-干扰素在肺炎支原体肺炎中的作用[J].中国实用儿科杂志,2008,23(4):269-271.
[14] PARSANEJAD R,FIELDS WR,STEICHEN TJ,et al. Distinct regulatory profiles of interleukins and chemokines in response to cigarette smoke condensate in normal human bronchial epithelial(NHBE)cells[J]. J Interferon Cytokine Res,2008,28(12):703-712.
[15] CHUSTZ RT,NAGARKAR DR,POPOSKI JA,et al. Regulation and function of the IL-1 family cytokine IL-1F9 in human bronchial epithelial cells[J]. Am J Respir Cell Mol Biol,2011,45(1):145-153.
[2] WAITES KB. New concepts of mycoplasma pneumoniae infections in children[J]. Pediatr Pulmonol,2003,36(4):267-278.
[3] KUMAR S,KAPOOR S,SAIGAL SR,et al. Hemorrhagic encephalitis caused by mycoplasma pneumoniae in an 11-year-old boy:a rare case report[J]. Indian J Med Microbiol,2015,33(3):463-464.
[4] PARK IH,CHOI DU Y,OH YK,et al. A case of acute myopericarditis associated with mycoplasma pneumoniae infection in a child[J]. Korean Circ J,2012,42(10):709-713.
[5] SIOMOU E,KOLLIOS KD,PAPADIMITRIOU P,et al. Acute nephritis and respiratory tract infection caused by mycoplasma pneumoniae:case report and review of the literature[J]. Pediatr Infect Dis J,2003,22(12):1103-1106.
[6]刘贺临,王立锁,郑申建,等.白细胞介素2和白细胞介素6在支原体肺炎患儿血清及诱导痰中表达及临床意义研究[J].中国实用儿科杂志,2011,26(8):592-595.
[7]潘薇,许忠,郑百红.肺炎支原体肺炎患儿急性期外周血IFN-γIL-4的变化[J].中国当代儿科杂志,2006,8(5):373-375.
[8] KURAI D,NAKAGAKI K,WADA H,et al. Mycoplasma pneumoniae extract induces an IL-17-associated inflammatory reaction in murine lung:implication for mycoplasmal pneumonia[J]. Inflammation,2013,36(2):285-293.
[9]王冬梅,姜采荣,王茹,等.肺炎支原体肺炎患儿血清白介素-23/白介素-17的表达[J].临床儿科杂志,2013,31(10):933-936.
[10]张群威,任志宏,程力平,等.肺炎支原体肺炎患儿外周血IL-10/IL-17表达与肺功能变化的相关性[J].安徽医药,2016,20(4):762-763.
[11] GABAY C,TOWNE JE. Regulation and function of interleukin-36cytokines in homeostasis and pathological conditions[J]. J Leukoc Biol,2015,97(4):645-652.
[12]张德凤,张彦萍,潘家华,等.儿童肺炎支原体肺炎143例临床分析[J].安徽医药,2013,17(7):1159-1162.
[13]左慧敏,刘秀云,江载芳.白介素8白介素10及γ-干扰素在肺炎支原体肺炎中的作用[J].中国实用儿科杂志,2008,23(4):269-271.
[14] PARSANEJAD R,FIELDS WR,STEICHEN TJ,et al. Distinct regulatory profiles of interleukins and chemokines in response to cigarette smoke condensate in normal human bronchial epithelial(NHBE)cells[J]. J Interferon Cytokine Res,2008,28(12):703-712.
[15] CHUSTZ RT,NAGARKAR DR,POPOSKI JA,et al. Regulation and function of the IL-1 family cytokine IL-1F9 in human bronchial epithelial cells[J]. Am J Respir Cell Mol Biol,2011,45(1):145-153.