■这项研究旨在调查淋巴细胞的水平,免疫球蛋白,促肾上腺皮质激素(ACTH)治疗前后婴儿痉挛(IS)和细胞因子的变化,并探讨这些标志物在评估ACTH对婴儿痉挛的治疗效果中的应用。
■2022年5月至11月,将35例最初诊断为IS并在我院治疗的儿童作为观察组,同期在我院体检的健康儿童35例作为对照组。观察组患儿肌内注射ACTH,疗程2周。采集对照组和观察组ACTH治疗前后的空腹静脉血。血清免疫球蛋白IgG水平,IgA,免疫比浊法检测血清IgM。T细胞亚群(CD3+,CD3+CD4+,和CD3+CD8+)和B细胞亚群[CD3-CD19+和CD3-CD56+自然杀伤(NK)细胞]通过流式细胞术检测,计算CD3+CD4+/CD3+CD8+比值。血清白细胞介素-1β(IL-1β)水平,白细胞介素-2R(IL-2R),和白细胞介素-6(IL-6)细胞因子通过酶联免疫吸附试验检测,比较两组患者治疗前血清细胞因子和免疫球蛋白水平的变化,而在观察第一组中,这些比较是在ACTH治疗前后进行的.
■与对照组相比,观察组治疗前血清免疫球蛋白IgG和IgM水平明显升高,而IgA水平显著降低(p<0.05)。此外,CD3-CD19+B细胞的百分比显着增加,而CD3+T细胞和CD3+CD4+T细胞的百分比显著降低(p<0.05)。CD3+CD8+T细胞的百分比,CD3-CD16+CD56+NK细胞,CD3+CD4+/CD3+CD8+细胞无明显变化(p>0.05);细胞因子IL-1β、IL-2R,IL-6明显升高(p<0.05)。与治疗前的水平相比,ACTH治疗后观察组血清免疫球蛋白IgG水平显著降低(p<0.05),而IgA和IgM水平无明显变化(p>0.05)。CD3+T细胞和CD3+CD4+T细胞的百分比显著增加,而CD3-CD16+CD56+NK细胞和CD3-CD19+B细胞的百分比显著降低(p<0.05);CD3+CD8+T细胞百分比和CD3+CD4+/CD3+CD8+比值无明显变化(p>0.05)。此外,细胞因子IL-1β的水平,IL-2R,IL-6显著降低(p<0.05)。
■IS患儿表现出免疫功能障碍,ACTH治疗后血清学免疫指标的变化表明ACTH可能通过调节和改善免疫功能障碍来控制IS患儿的癫痫发作。因此,ACTH对IS的治疗效果可以通过检测细胞因子和免疫球蛋白的水平来评估。
UNASSIGNED: This research aims to investigate the levels of lymphocytes, immunoglobulins, and cytokines in children with infantile spasms (IS) before and after adrenocorticotropic hormone (ACTH) therapy and to explore the application of these markers in evaluating the therapeutic effects of ACTH on infantile spasms.
UNASSIGNED: From May to November 2022, 35 children initially diagnosed with IS and treated at our hospital were regarded as the observation group, and 35 healthy children who underwent physical examination at our hospital during the same period were regarded as the control group. Children in the observation group received intramuscular injections of ACTH for 2 weeks. Fasting venous blood was collected from the control group and the observation group before and after ACTH therapy. Serum levels of immunoglobulins IgG, IgA, and IgM in serum were detected by immunoturbidimetry. T-cell subsets (CD3+, CD3+CD4+, and CD3+CD8+) and B-cell subsets [CD3-CD19+ and CD3-CD16+CD56+ natural killer (NK) cells] were detected by flow cytometry, and the ratio of CD3+CD4+/CD3+CD8+ was calculated. Serum levels of interleukin-1β (IL-1β), interleukin-2R (IL-2R), and interleukin-6 (IL-6) cytokines were detected by the enzyme-linked immunosorbent assay, and changes in serum cytokine and immunoglobulin levels in the two groups were compared before therapy, whereas in observation group one, these comparisons were made both before and after ACTH therapy.
UNASSIGNED: Compared to the control group, the observation group showed significantly increased serum levels of immunoglobulins IgG and IgM before therapy, while the level of IgA was significantly decreased (p < 0.05). Also, the percentage of CD3-CD19+ B cells was significantly increased, while the percentages of CD3+ T cells and CD3+CD4+ T cells were significantly decreased (p < 0.05). The percentages of CD3+CD8+ T cells, CD3-CD16+CD56+ NK cells, and CD3+CD4+/CD3+CD8+ cells did not change significantly (p > 0.05); the levels of cytokines IL-1 β, IL-2R, and IL-6 were significantly increased (p < 0.05). Compared to levels before treatment, the serum level of immunoglobulin IgG in the observation group after ACTH therapy was significantly reduced (p < 0.05), while the IgA and IgM levels did not change significantly (p > 0.05). The percentages of CD3+ T cells and CD3+CD4+ T cells were significantly increased, while the percentages of CD3-CD16+CD56+ NK cells and CD3-CD19+ B cells were significantly decreased (p < 0.05); however, the percentages of CD3+CD8+ T cells and the CD3+CD4+/CD3+CD8+ ratio did not change significantly (p > 0.05). Furthermore, the levels of cytokines IL-1 β, IL-2R, and IL-6 were significantly reduced (p < 0.05).
UNASSIGNED: Children with IS exhibit immune dysfunction, and the changes in serological immune indices after ACTH treatment indicate that ACTH may control seizures in IS children by regulating and improving immune dysfunction. Therefore, the therapeutic effects of ACTH on IS can be evaluated by detecting the levels of cytokines and immunoglobulins.