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目的:探讨口服卡介苗(BCG)对哮喘患者外周血Th_1/Th_2平衡、嗜酸性粒细胞(EOS)和IgE水平的影响。方法:对40例急性发作期的哮喘患者(治疗组)在常规治疗的基础上加用BCG口服(50mg/支),100mg用5%碳酸氢钠溶液250ml稀释后饭前口服,每周1次,共16周。分别在治疗前后采用双抗体夹心ELISA法检测外周血培养上清单个核细胞(PBMC)中白介素-4(IL-4)和γ-干扰素(IFN-γ)水平,同时测定外周血IgE和嗜酸性粒细胞(EOS)计数,并进行肺功能的测定。并以同期入选的健康体检者30例作对照(对照组)。结果:治疗组患者治疗前外周血IL-4、IgE水平和EOS细胞数明显高于对照组,而IFN-γ水平明显低于对照组(P<0.05或P<0.01),经BCG口服治疗16周后患者外周血IL-4、IgE水平和EOS细胞数均明显降低,而IFN-γ水平明显上升(P均<0.05);同时患者肺功能指标FVC、FEV_1和PEF均明显改善(均P<0.05)。结论:哮喘患者存在外周血Th_1/Th_2平衡失调。口服BCG治疗哮喘的临床疗效确切,作用机制可能通过纠正外周血,Th_1/Th_2细胞因子平衡,抑制EOS聚集,使B细胞分泌IgE减少,从而改善患者肺功能,达到治疗哮喘的目的。
Objective: To investigate the effect of oral BCG on Th1 / Th2 balance, eosinophil (EOS) and IgE levels in peripheral blood of asthmatic patients. Methods: Forty patients with acute exacerbation of asthma (treatment group) were given BCG orally (50mg / support) on the basis of conventional treatment, 100mg diluted with 250ml of 5% sodium bicarbonate solution before meals and once a week , A total of 16 weeks. The levels of interleukin-4 (IL-4) and interferon-γ (IFN-γ) in peripheral blood mononuclear cells (PBMCs) were detected by double antibody sandwich ELISA before and after treatment. Acidic granulocytes (EOS) were counted and lung function was measured. 30 healthy subjects were enrolled in the same period (control group). Results: Before treatment, the levels of IL-4 and IgE and the number of EOS in peripheral blood of patients in treatment group were significantly higher than those in control group, while the levels of IFN-γ in treatment group were significantly lower than those in control group (P <0.05 or P <0.01) The level of IL-4 and IgE and the number of EOS in peripheral blood of patients were significantly decreased (P <0.05), while the levels of IFN-γ and IFN-γ in peripheral blood of patients were significantly decreased (P < 0.05). Conclusion: Th1 / Th2 balance disorder exists in asthmatic patients. Oral BCG treatment of asthma clinical curative effect, the mechanism may be by correcting the peripheral blood, Th_1 / Th_2 cytokine balance, inhibition of EOS aggregation, so that the secretion of IgE B cells decreased, thereby improving lung function in patients with the purpose of treatment of asthma.