变应原特异性免疫治疗过敏性鼻炎患儿的临床疗效及其与Treg细胞水平的相关性

钱晓婷; 邵磊; 张骏

doi:10.16766/j.cnki.issn.1674-4152.004171

变应原特异性免疫治疗过敏性鼻炎患儿的临床疗效及其与Treg细胞水平的相关性

doi: 10.16766/j.cnki.issn.1674-4152.004171

钱晓婷^1, ,,
邵磊¹,
张骏²

1.
浙江省人民医院淳安分院药剂科，浙江杭州 311700
2.
浙江省人民医院淳安分院儿科
3.
浙江省中医院消化内科，浙江杭州 310000

基金项目:

浙江省医药卫生科技计划项目 2023XY014

详细信息

通讯作者:
钱晓婷，E-mail: qianxiaoting2022@163.com

中图分类号: R765.21 R457.2
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出版历程
- 收稿日期: 2024-08-18
- 网络出版日期: 2025-11-17

Clinical efficacy of allergen-specific immunotherapy in Children with allergic rhinitis and its correlation with Treg cell levels

1.
Department of Pharmacy, Chun' an Branch of Zhejiang Provincial People' s Hospital, Hangzhou, Zhejiang 311700, China

摘要

摘要: 目的变应原特异性免疫疗法是一种新型脱敏疗法，但其疗效可能受患儿免疫反应水平的影响。本研究旨在探讨变应原特异性免疫疗法治疗过敏性鼻炎的临床疗效及与患儿免疫反应水平的相关性。方法纳入2020年1—11月于浙江省人民医院淳安分院就诊的100例过敏性鼻炎患儿，根据治疗意愿将患儿分为使用变应原特异性免疫治疗的观察组和使用常规治疗的对照组，每组50例。比较2组临床疗效、肺功能、过敏原特异性免疫球蛋白E水平(sIgE)、外周血Treg细胞水平，并利用Pearson相关分析研究外周血Treg细胞表达水平与治疗效果的相关性。结果治疗结束时和治疗后1、3个月观察组鼻部症状总评分(TNSS)均低于对照组，CD4⁺CD25⁺Foxp3⁺Treg细胞水平[(8.54±1.07)%、(8.56±1.12)%、(8.79±1.33)%]均高于对照组[(8.00±1.15)%、(8.05±1.32)%、(8.03±1.17)%, P < 0.05]，治疗完成后1个月、3个月观察组sIgE水平均低于对照组(P < 0.05)，但组间第1秒用力呼气容积占预计值百分比(FEV₁% pred)水平比较，差异均无统计学意义(P>0.05)。观察组治疗完成后3个月TNSS评分与Treg细胞水平呈负相关关系(r=-0.469，P < 0.05)，对照组中二者无相关性(P>0.05)。结论皮下变应原特异性免疫治疗过敏性鼻炎患儿可有效提高临床疗效，降低sIgE，上调外周血Treg细胞水平，且临床疗效与Treg细胞水平呈负相关关系。
- 过敏性鼻炎 /
- 皮下变应原特异性免疫治疗 /
- Treg细胞 /
- 细胞因子
Abstract: Objective Allergen-specific immunotherapy (ASIT) is a novel desensitization therapy for allergic diseases. However, its efficacy may be influenced by the immune response levels in children. Therefore, this study aimed to evaluated the clinical efficacy of ASIT in the treatment of allergic rhinitis and to investigate its correlation with Treg cell levels. Methods A total of 100 children with allergic rhinitis who were treated at Chun' an Branch of Zhejiang Provincial People' s Hospital from January to November 2020 were enrolled. According to their treatment willingness, the children were divided into an observation group receiving allergen-specific immunotherapy and a control group receiving conventional treatment, with 50 cases in each group. The clinical efficacy, lung function, allergen-specific immunoglobulin E level (sIgE), and peripheral blood Treg cell level were compared between the two groups. The Pearson correlation coefficient was used to analyze the correlation between the levels of peripheral Treg cell and the treatment efficacy. Results At the end of treatment, 1 month and 3 month after treatment, the total nasal symptom score (TNSS) in the observation group was lower than that in the control group. The levels of CD4⁺CD25⁺Foxp3⁺ Treg cells in the observation group [(8.54±1.07)%, (8.56±1.12)%, (8.79±1.33)%] were higher than those in the control group [(8.00±1.15)%, (8.05±1.32)%, (8.03±1.17)%, P < 0.05]. At both 1 month and 3 months post-treatment, the sIgE levels in the observation group were lower than those in the control group (P < 0.05). However, there was no statistically significant difference in the predicted percentage of forced expiratory volume in 1 second (FEV₁% pred) between the two groups (P>0.05). In the observation group, the TNSS score at 3 months post-treatment completion was negatively correlated with the level of Treg cells (r=-0.469, P < 0.05), whereas no significant correlation was observed in the control group (P>0.05). Conclusion Subcutaneous allergen-specific immunotherapy is effective in improving clinical symptoms in children with allergic rhinitis, as evidenced by reduced serum sIgE levels, and increased peripheral blood Treg cell levels. Furthermore, the clinical efficacy is negatively correlated with Treg cell levels.
- Allergic rhinitis /
- Subcutaneous allergen specific immunotherapy /
- Treg cells /
- Cytokine

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表 1 2组过敏性鼻炎患儿一般资料比较

Table 1. Comparison of general data between two groups of children with allergic rhinitis

组别	例数	年龄(x±s，岁)	性别(男/女，例)	病程(x±s，月)	疾病严重程度[例(%)]
组别	例数	年龄(x±s，岁)	性别(男/女，例)	病程(x±s，月)	中度	重度
对照组	50	15.43±2.32	23/27	3.81±1.26	31(62.00)	19(38.00)
观察组	50	14.76±2.00	26/24	4.07±1.40	34(68.00)	16(32.00)
统计量		1.547^a	0.360^b	0.976^a	0.396^b
P值		0.125	0.548	0.331	0.529
注：^a为t值，^b为χ²值。

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表 2 2组过敏性鼻炎患儿治疗前后TNSS评分比较(x ±s，分)

Table 2. Comparison of TNSS scores before and after treatment between two groups of children with allergic rhinitis(x ±s, points)

组别	例数	治疗前	治疗结束时	治疗完成后1个月	治疗完成后3个月
对照组	50	4.24±1.07	1.74±0.53	1.85±0.57	1.88±0.60
观察组	50	4.39±1.42	1.42±0.41	1.36±0.42	1.40±0.35
F值		1.761	2.361	1.842	2.939
P值		0.050	0.003	0.035	< 0.001

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表 3 2组过敏性鼻炎患儿治疗前后肺功能比较(x ±s，%)

Table 3. Comparison of lung function before and after treatment between two groups of children with allergic rhinitis(x ±s, %)

组别	例数	治疗前	治疗结束时	治疗完成后 1个月	治疗完成后 3个月
对照组	50	85.75±15.89	89.02±16.13	90.74±13.28	89.77±16.53
观察组	50	87.31±18.12	88.16±18.25	92.40±13.44	91.89±12.58
F值		1.300	1.280	1.024	1.727
P值		0.361	0.390	0.934	0.059

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表 4 2组过敏性鼻炎患儿治疗前后sIgE水平比较(x ±s，U/mL)

Table 4. Comparison of sIgE levels before and after treatment between two groups of children with allergic rhinitis(x ±s, U/mL)

组别	例数	治疗前	治疗结束时	治疗完成后1个月	治疗完成后3个月
对照组	50	382.63±72.12	163.48±50.72	156.61±31.77	163.25±40.68
观察组	50	375.51±68.37	154.42±47.26	141.33±39.35	139.21±34.12
F值		1.113	1.152	1.871	1.872
P值		0.710	0.623	0.031	0.030

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表 5 2组过敏性鼻炎患儿治疗前后CD4⁺CD25⁺Foxp3⁺Treg细胞水平比较(x ±s，%)

Table 5. Comparison of CD4⁺CD25⁺Foxp3⁺ Treg cell levels before and after treatment between two groups of children with allergic rhinitis(x ±s, %)

组别	例数	治疗前	治疗结束时	治疗完成后1个月	治疗完成后3个月
对照组	50	7.49±1.03	8.00±1.15	8.05±1.32	8.03±1.17
观察组	50	7.37±1.22	8.54±1.07	8.56±1.12	8.79±1.33
F值		1.403	2.098	2.092	2.186
P值		0.240	0.011	0.011	0.007

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表 6 对照组过敏性鼻炎患儿外周血CD4⁺CD25⁺Foxp3⁺Treg细胞表达水平与TNSS评分的相关性分析

Table 6. Correlation analysis between peripheral blood Treg cell expression levels and treatment efficacy in the control group

项目	治疗前		治疗结束时		治疗完成后1个月		治疗完成后3个月
项目	r值	P值	r值	P值	r值	P值	r值	P值
治疗结束时TNSS评分	0.019	0.898	0.110	0.447	0.076	0.601	0.093	0.519
治疗完成后1个月TNSS评分	0.129	0.373	-0.091	0.527	0.068	0.640	-0.091	0.528
治疗完成后3个月TNSS评分	-0.062	0.666	0.082	0.569	-0.120	0.405	0.117	0.420

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表 7 观察组过敏性鼻炎患儿外周血CD4⁺CD25⁺Foxp3⁺Treg细胞表达水平与TNSS评分的相关性分析

Table 7. Correlation analysis between peripheral blood Treg cell expression levels and treatment efficacy in the observation group

项目	治疗前		治疗结束时		治疗完成后1个月		治疗完成后3个月
项目	r值	P值	r值	P值	r值	P值	r值	P值
治疗结束时TNSS评分	-0.018	0.900	-0.086	0.550	-0.108	0.457	-0.129	0.373
治疗完成后1个月TNSS评分	-0.074	0.616	-0.157	0.275	-0.192	0.182	-0.231	0.106
治疗完成后3个月TNSS评分	-0.291	0.040	-0.317	0.025	-0.325	0.021	-0.469	< 0.001

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