目的：研究支气管哮喘儿童血清25-羟维生素D3［25-（OH）D3］和总免疫球蛋白E（TIgE）的变化及临床意义。方法采用放射免疫分析法，检测30例支气管哮喘、40例喘息性支气管炎患儿及40例正常对照儿童血清25-（OH）D3及TIgE含量，比较3组间其血清含量的差异。结果支气管哮喘组血清25-（OH）D3含量（18±3 ng/mL）明显低于喘息性支气管炎组（43±3 ng/mL）和正常对照组（43±3 ng/mL），且TIgE含量（192±16 IU/mL）明显高于喘息性支气管炎组（123±14 IU/mL）和正常对照组（118±15 IU/mL），差异均有统计学意义（P＜0.01）。支气管哮喘组血清25-（OH）D3与TIgE呈负相关（r=-0.783，P＜0.01＝，喘息性支气管炎组、正常对照组血清25-（OH）D3与TIgE均无相关性。结论血清25-（OH）D3缺乏可能是导致儿童支气管哮喘发作的原因。血清25-（OH）D3水平增高可以抑制IgE的过度表达，这可能成为预防和治疗支气管哮喘等过敏性疾病的一种新的有效途径。
Abstract
OBJECTIVE: To study the changes and clinical significance of serum levels of 25-(OH)D3 and total IgE in children with asthma. METHODS: Thirty children with asthma, 40 children with asthmatic bronchitis, and 40 healthy children were enrolled. Double-antibody radioimmunoassay was used to detect the levels of serum 25-(OH)D3 and total IgE. RESULTS: Serum 25-(OH)D3 levels (18±3 ng/Ml)decreased significantly in the asthmatic group compared with those in the asthmatic bronchitis group (43±3 ng/mL) and the control group (43±3 ng/mL) (P＜0.01). In contrast, serum total IgE levels (192±16 IU/mL) increased significantly in the asthmatic group compared with those in the asthmatic bronchitis group (123±14 IU/mL) and the control group (118±15 IU/mL) (P<0.01). Serum 25-(OH)D3 levels were negatively correlated with serum total IgE levels in asthmatic children (r=-0.783, P<0.01). There were no correlation between serum 25-(OH)D3 levels and serum total IgE level in the asthmatic bronchitis and the control groups. CONCLUSIONS: 25-(OH)D3 may play an important role in the pathogenesis of asthma. The increased serum 25-(OH)D3 level may inhibit total IgE expression, suggesting that increasing serum 25-(OH)D3 level might be a new option for the prevention and treatment of asthma.
关键词
支气管哮喘 /
喘息性支气管炎 /
25-羟维生素D3 /
总免疫球蛋白E /
儿童
Key words
Asthma /
Asthmatic bronchitis /
25-(OH)D3 /
Total IgE /
Child
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
［1］张建华.支气管哮喘的流行病学及高危因素［J］.实用儿科临床杂志，2008，23（4）：241-243.
［2］杨锡强.小儿哮喘的免疫学发病机制及其对策［J］.中国当代儿科杂志,2001,3(5):487-490.
［3］Barnes PJ．Immunology of asthma and chronic obstructive pulmonary disease［J］．Nat Rev Immunol, 2008, 8(3): 183-192.
［4］邹宁,李晓环. 维生素D抵抗研究进展［J］.中国儿童保健杂志,2009,17(2):186188.
［5］Matheu V, Bock O, Mondoc E, Issazadeh-Navikas S. Dual effects of vitamin D-induced alteration of Th1/Th2 cytokine expression: enhancing IgE production and decreasing airway eosinophilia in murine allergic airway disease［J］.J Allergy Clin Immunol, 2003, 112(3): 585592.
［6］中华医学会儿科学分会呼吸学组,中华医学会《中华儿科杂志》编辑委员会．儿童支气管哮喘防治常规(试行)［J］．中华儿科杂志，2004，42(2)：100-106.
［7］赵凯，向伟．联合疗法治疗儿童哮喘临床观察［J］．中国热带医学，2002，2(4)：469-471.
［8］Camargo CA Jr, Rifas-Shiman SL, Litonjua AA, Rich-Edwards JW, Weiss ST, Gold DR, et al. Maternal intake of vitamin D during pregnancy and risk of recurrent wheeze in children at 3 y of age［J］.Am J Clin Nutr, 2007, 85（3）: 788-795.
［9］张巧玲，周小建，洪建国. 生命早期补充维生素D对哮喘大鼠白细胞介素10和细胞间黏附分子1表达的影响［J］.中华儿科杂志，2009,47（10）：735-739.
［10］蔡绍曦，高枫，丁彦青，赵海金，李文军，邹飞．维生素D3上调蛋白l在哮喘嗜酸粒细胞中的表达及其与细胞活化的关系［J］．中国病理生理杂志，2007，23(6)：1120-1124.
［11］范永琛．小儿哮喘与“喘息性支气管炎”的区别［J］．中华儿科杂志，2006，44(1)：68-70.
［12］Hypp-nen E, Berry DJ, Wjst M, Power C. Serum 25-hydroxyvitamin D and IgE-a significant but nonlinear relationship［J］.Allergy, 2009, 64(4): 613-620.
［13］Brehm JM, Celedón JC, Soto-Quiros ME, Avila L, Hunninghake GM, Forno E, et al. Serum vitamin D levels and markers of severity of childhood asthma in Costa Rica［J］．Am J Respir Crit Care Med, 2009, 179(9): 765-771.
［14］Daniel C, Sartory NA, Zahn N, Radeke HH, Stein JM. Immune modulatory treatment of trinitrobenzene sulfonic acid colitis with calcitriol is associated with a change of a T helper (Th) 1/Th17 to a Th2 and regulatory T cell profile［J］. J Pharmacol Exp Ther, 2008, 324(1): 23-33.
［15］谢克信，王先峰．支气管哮喘与慢性喘息性支气管炎的鉴别［J］．中华现代中西医杂志，2005，3(17)：1546.
PDF(965 KB)
