目的 探讨儿童过敏性鼻炎(allergic rhinitis,AR)和支气管哮喘(bronchial asthma,BA)患儿外周血高迁移率族蛋白B1(high mobility group box 1,HMGB1)水平与辅助性T细胞17(T helper 17 cell,Th17)和调节性T细胞(regulatory T cell,Treg)的比例(Th17/Treg)的相关性.方法 采用前瞻性研究方法,选取2023年3月至12月在解放军总医院第七医学中心门急诊就诊患儿及健康体检者共113例作为研究对象,按照临床症状分成健康对照组(n=25)、过敏性鼻炎组(AR组,n=28)、支气管哮喘组(BA组,n=31)和两者并有组(AR+BA组,n=29),比较4组肺功能、免疫球蛋白E(immunoglobulin E,IgE)、白细胞介素(interleukin,IL)-17、HMGB1水平和Th17/Treg比例.统计学方法采用t检验、方差分析和Pearson相关性分析.结果 各组的第1秒用力呼气容积(forced expiratory volume in the first second,FEV1)的结果显示,健康对照组高于AR组、BA组和AR+BA组[(96.4±2.5)%、(90.7±4.9)%、(88.6±4.1)%、(82.1±5.5)%,F=47.193,P值均<0.001],显示AR和BA患儿肺功能可能变差.AR组、BA组和AR+BA组HMGB1水平高于健康对照组[(30.4±12.4)mg/L、(47.2±17.8)mg/L、(51.4±21.8)mg/L、(4.3±2.1)mg/L,F=48.896,P值均<0.001].AR组、BA组和AR+BA组Th17/Treg比例高于健康对照组(0.68±0.14、0.71±0.14、1.36±0.40、0.30±0.07,F=105.547,P值均<0.001).Pearson相关性分析结果显示,HMGB1与Th17(r=0.521,P<0.001)、Th17/Treg(r=0.419,P<0.05)、IgE(r=0.502,P<0.05)、IL-17(r=0.472,P<0.05)呈正相关,与FEV1(r=-0.645,P<0.001)呈负相关.结论 在儿童AR合并BA的发病过程中,HMGB1水平及Th17细胞百分比增加,而Treg细胞百分比降低,Th17/Treg比例存在失衡的情形,HMGB1水平与Th17细胞百分比、Th17/Treg比例、IgE、IL-17及FEV1存在一定的相关性,HMGB1和Th17/Treg的动态平衡可能通过影响细胞因子的表达而起到一定的调节作用.
Changes and correlation between peripheral HMGB1 and Th17/Treg in children with allergic rhinitis and bronchial asthma
Objective To investigate the correlation between the high mobility group box 1 (HMGB1)and T helper 17 cell/regulatory T cell (Th17/Treg) in peripheral blood of children with allergic rhinitis (AR) and bronchial asthma (BA).Method A prospective study was used to select 113 children and healthy physical examination subjects in the Department of Outpatient and Emergency,the Seventh Medical Center of Chinese PLA General Hospital from March to December 2023.According to clinical symptoms,they were divided into healthy control group (n=25),allergic rhinitis group (AR group,n=28),bronchial asthma group (BA group,n=31) and both groups (AR+BA group,n=29).The lung function,immunoglobulin E (IgE),interleukin (IL)-17 HMGB1 level and Th17/Treg were compared between the four groups.Statistical methods performed by t-test,analysis of variance,and Pearson correlation analysis.Result The results of the forced expiratory volume in the first second (FEV1) in each group showed that,the healthy control group was higher than that in the AR group,BA group and AR+BA group[(96.4±2.5)%,(90.7±4.9)%,(88.6±4.1)%,(82.1±5.5)%,F=47.193,P<0.001],indicating that lung function may be deteriorated in children with AR and BA.The level of HMGB1 in AR group,BA group and AR+BA group was higher than that in the healthy control group[(30.4±12.4) mg/L,(47.2±17.8) mg/L,(51.4±21.8) mg/L and (4.3±2.1) mg/L,F=48.896,all P<0.001].Th17/Treg in AR group,BA group and AR+BA group was higher than that in the healthy control group (0.68±0.14,0.71±0.14,1.36±0.40,0.30±0.07),F=105.547,all P<0.001).Pearson correlation analysis showed that HMGB1 was positively correlated with Th17 (r=0.521,P<0.001),Th17/Treg (r=0.419,P<0.05),IgE (r=0.502,P<0.05),IL-17 (r=0.472,P<0.05),and was negatively correlated with FEV1 (r=-0.645,P<0.001).Conclusion In the pathogenesis of AR combined with BA in children,the level of HMGB1 and the percentage of Th17 cell increased,while the percentage of Treg cell decreased,and there is an imbalance of Th17/Treg.There is a certain relationship between the level of HMGB1 and percentage of Th17 cells,Th17/Treg,IgE,IL-17 and FEV1,the homeostasis of HMGB1 and Th17/Treg may play a certain regulatory role by affecting the expression of cytokines.
Allergic rhinitisBronchial asthmaHigh mobility group box 1T helper 17 cellTegulatory T cell
万方数据
维普
