标准化粉尘螨滴剂舌下免疫治疗变应性鼻炎患儿的疗效及TGF-β和IL-13 mRNA表达水平的变化

武勇进; 王鹏; 刘智献; 邱书奇

doi:10.13201/j.issn.1001-1781.2018.04.004

标准化粉尘螨滴剂舌下免疫治疗变应性鼻炎患儿的疗效及TGF-β和IL-13 mRNA表达水平的变化

- 深圳市耳鼻咽喉科研究所深圳市龙岗区耳鼻咽喉医院(深圳, 518172)
基金项目:
深圳市科技计划项目（No：JCYJ20170302165551401）；深圳市龙岗区经济与科技发展专项资金（No：20160607172452264）

详细信息

通讯作者: 武勇进,E-mail:entwyj@163.com

中图分类号: R765.21

收稿日期: 2017-11-26

Efficacy of sublingual immunotherapy with dermatophagoides farinae drops in children with allergic rhinitis and the change of TGF-β and IL-13 mRNA level

- Shenzhen Longgang ENT Hospital, Shenzhen ENT Institute, Shenzhen, 518172, China

More Information

Corresponding author: WU Yongjin, E-mail: entwyj@163.com

Received Date: 26 November 2017

摘要

摘要: 目的：评估标准化粉尘螨滴剂舌下特异性免疫治疗对儿童变应性鼻炎（AR）的疗效，检测经12个月免疫治疗后TGF-β和IL-13 mRNA表达水平的改变。方法：收集AR患儿92例，随机分为SLIT组（62例）和对照组（30例），前者以标准化粉尘螨滴剂舌下含服免疫治疗，辅以药物对症治疗，后者单纯使用药物对症治疗，分别在治疗前、治疗6个月和12个月后，评估患儿的鼻部症状评分和总用药评分变化。此外，通过qRT-PCR检测AR患儿经过免疫治疗后外周血单核细胞中TGF-β和IL-13 mRNA表达水平的变化。结果：经过12个月的治疗后，SLIT组的症状评分和用药评分显著低于对照组（P<0.01）。经舌下免疫治疗后，症状控制良好、部分控制和未控制者分别为45.2%、32.3%和22.6%。92例患儿中5例（5.4%）出现局部不良反应，1例（1.1%）出现轻微全身不良反应，均未出现严重全身不良反应。症状控制良好的患儿，与治疗前相比，TGF-β的mRNA表达水平上升，IL-13 mRNA的表达水平下降。结论：标准化粉尘螨滴剂舌下免疫治疗AR能明显改善过敏症状，减少对症药物的使用，且安全性高。TGF-β和IL-13 mRNA表达水平的变化可能作为评价舌下免疫治疗疗效的指标。
- 鼻炎,变应性 /
- 粉尘螨 /
- 儿童 /
- 舌下免疫疗法 /
- TGF-β /
- 白细胞介素13
Abstract: Objective: The aim of this study is to evaluate the efficacy of sublingual immunotherapy (SLIT) with standardized dermatophagoides farinae drops and to examine the change of TGF-β and IL-13 mRNA level after 12 months SLIT in children with allergic rhinitis (AR).Method: Ninety-two children with AR were collected and randomly divided into two groups:SLIT group (n=62) and control group (n=30). Before and after SLIT for 6 months and 12 months, total nasal symptoms score (TNSS) and total medication score (TMS) were evaluated. In addition, the mRNA expression of TGF-β and IL-13 in peripheral blood mononuclear cells of AR children after immunotherapy were examined by qRT-PCR.Result: There were significant differences (P<0.01) in symptom and medication scores between the two groups after 12 months treatment. The patients in SLIT group had fewer symptoms and lower intake of medication.The rates for well controlled, partly controlled and uncontrolled children were 45.2%, 32.3% and 22.6%, respectively. Five children (5.4%) experienced local adverse events and 1 children (1.1%) experienced mild systemic adverse events. No severe adverse events happened during the treatment. Accordingly, comparing with the baseline value, the mRNA levels of TGF-β increased significantly, and IL-10 mRNA level decreased significantly in well controlled children after 12 months treatment.Conclusion: SLIT with dermatophagoides farinae drops is efficient and safe treatment for children with HDM induced AR. The change of TGF-β and IL-13 mRNA level may be considered as an indicator for evaluating the clinical efficacy of SLIT.
- rhinitis, allergic /
- dermatophagoides farinae /
- child /
- Sublingual immunotherapy /
- TGF-β /
- IL-13

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