2018 年第 5 期 第 13 卷

支气管哮喘合并佝偻病患儿血清维生素D水平与辅助性T细胞1/辅助性T细胞2和辅助性T细胞17/调节性T细胞平衡的关系

Relation between serum vitamin D and the balance of helper T cell 1/helper T cell 2, helper T cell 17/regulatory T cell immune response in bronchial asthma children with rickets

作者：欧灵谢增辉方萍潘建丽

英文作者：

单位：710003西安市儿童医院特需科（欧灵、谢增辉、潘建丽）；710000西安交通大学第二附属医院呼吸内科（方萍）

英文单位：

关键词：支气管哮喘；维生素D；辅助性T细胞；调节性T细胞

英文关键词：

• 摘要：

• 目的    探讨支气管哮喘合并佝偻病患儿血清维生素D水平与辅助性T细胞（Th）1/Th2、Th17/调节性T细胞（Treg）免疫应答平衡的关系。方法    选取2016年6月至2017年5月西安市儿童医院确诊支气管哮喘且合并佝偻病的126例患儿作为支气管哮喘组；选取同期进行疫苗接种的健康儿童100例作为正常对照组。检测2组儿童血清25羟基维生素D［25-(OH)D］水平，外周血Th1、Th2、Th17、Treg及相关细胞因子的含量。采用Pearson检验分析支气管哮喘患儿血清25-(OH)D水平与Th1/Th2、Th17/Treg平衡的相关性。结果    支气管哮喘组血清25-(OH)D水平明显低于正常对照组［（58±6）nmol/L比（95±10）nmol/L］，差异有统计学意义（P＜0.05）。支气管哮喘组外周血Th1比例明显低于、Th2比例明显高于正常对照组；Th1细胞因子白细胞介素（IL）2和干扰素γ水平明显低于、Th2细胞因子IL-4和IL-10水平明显高于正常对照组（均P＜0.05）。支气管哮喘组外周血Th17比例明显高于、Treg比例明显低于正常对照组［（1.04±0.13）%比（0.72±0.09）%、（8.6±1.0）%比（10.7±1.4）%］；IL-17水平明显高于、IL-35水平明显低于正常对照组［（34.6±4.2）ng/L比（20.3±2.9）ng/L、（48±5）ng/L比（61±8）ng/L］，差异均有统计学意义（均P＜0.05）。Pearson检验显示，支气管哮喘组血清25-(OH)D水平与Th1比例及IL-2、干扰素γ水平呈正相关，与Th2比例及IL-4、IL-10水平呈负相关，与Th17比例及IL-17水平呈负相关，与Treg比例及IL-35水平呈正相关（均P＜0.05）。结论    支气管哮喘合并佝偻病患儿维生素D的缺乏程度与免疫应答异常直接相关。

• 【Abstract】Objective    To analyze the relation between serum vitamin D and the balance of helper T cell（Th） 1/Th 2, Th 17/regulatory T cell（Treg） immune response in bronchial asthma children with rickets. Methods    From June 2016 to May 2017, 126 children with bronchial asthma complicated with rickets（bronchial asthma group） and 100 healthy children（normal control group） were enrolled in Xi′an Children′s Hospital. Serum 25-hydroxyl vitamin D［25-(OH)D］, peripheral blood Th1, Th2, Th17, Treg and related cytokines were detected. Relations between 25-(OH)D level and Th1/Th2, Th17/Treg immune response balance were analyzed by the Pearson test. Results    Serum level of 25-(OH)D in bronchial asthma group was significantly lower than that in normal control group［（58±6）nmol/L vs （95±10）nmol/L］(P＜0.05). Peripheral blood Th1 ratio in bronchial asthma group was significantly lower and Th2 ratio was significantly higher than those in normal control group; levels of Th1 cytokine interleukin（IL）2 and interferon-γ in bronchial asthma group were significantly lower, levels of Th2 cytokine IL-4 and IL-10 were significantly higher than those in normal control group(P＜0.05). Peripheral blood Th17 ratio in bronchial asthma group was significantly higher and Treg ratio was significantly lower than those in normal control group［（1.04±0.13）% vs （0.72±0.09）%, （8.6±1.0）% vs （10.7±1.4）%］; Th17 cytokine IL-17 in bronchial asthma group was significantly higher and Treg cytokine IL-35 was significantly lower than those in normal control group［（34.6±4.2）ng/L vs （20.3±2.9）ng/L, （48±5）ng/L vs （61±8）ng/L］(P＜0.05). Pearson test showed that serum 25-(OH)D level was positively correlated with Th1 ratio, IL-2 level, interferon-γ level, Treg ratio and IL-35 level; it is negatively correlated with Th2 ratio, IL-4 level, IL-10 level, Th17 ratio and IL-17 level（P＜0.05）. Conclusion    Vitamin D deficiency in children suffering from bronchial asthma accompanied by rickets is associated with the immune response abnormality.

  【Key words】Bronchial asthma;Vitamin D;Helper T cell;Regulatory T cell