IMMUNOLOGICAL MARKERS INDICATING THE EFFECTIVENESS OF PHARMACOLOGICAL TREATMENT IN HUMAN HYDATID-DISEASE
IMMUNOLOGICAL MARKERS INDICATING THE EFFECTIVENESS OF PHARMACOLOGICAL TREATMENT IN HUMAN HYDATID-DISEASE
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DOI：
10.1111/j.1365-2249.1995.tb03778.x
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发表时间：
1995-11-01
影响因子：
4.6
通讯作者：
SIRACUSANO, A
中科院分区：
文献类型：
--
作者：
RIGANO, R;PROFUMO, E;SIRACUSANO, A
对27例细粒棘球蚴病患者按阿苯达唑/甲苯达唑治疗有效性（完全、部分、低应答和无效）分为4组，观察其干扰素-γ（IFN-γ）、白细胞介素-4（IL-4）、白细胞介素-10（IL-10）的产生及特异性IgE、总IgG、IgG亚类的表达与药物治疗效果的关系。在寄生虫抗原刺激后，来自完全应答者的外周血单核细胞（PBMC）产生比来自非应答者的PBMC显著更多的IFN-γ（P=0.038）、显著更少的IL-4（P=0.001）和更少的IL-10。来自部分和低应答者的PBMC产生中等细胞因子浓度。ELISA测定免疫球蛋白的产生表明，所有无应答者的血清均含有IgE和IgG 4抗体，两者均受IL-4调节。与IgG 4相反，IgE在完全应答者中迅速下降。完全应答者也显示最高百分比的IgG 3反应。通过免疫印迹法测定的棘球蚴患者血清中总IgG反应的定性分析显示，四组治疗患者与棘球蚴囊液抗原的结合特征不同。无应答者对抗原5和B的所有亚单位的反应百分比最高，完全应答者对单独的抗原5的反应百分比最高。在完全应答者中，高IFN-γ产生与IL-4缺乏和低IL-10产生相关，反之亦然，在非应答者中，高IL-4和IL-10产生与IFN-γ产生缺乏或低相关，这意味着保护性免疫中的Th 1细胞活化和对包虫病易感性中的Th 2细胞活化。在治疗前特异性IgE抗体阳性的包虫病人中，IgE可能是治疗成功的一个有用的标志物。包虫抗原的IgG亚类反应和不同免疫球蛋白亚类结合模式也可用于包虫病的免疫监测。
The relation of interferon-gamma (IFN-gamma), IL-4, IL-10 production and specific IgE, total IgG, IgG subclass expression to the effectiveness of pharmacological treatment in human hydatid disease (Echinococcus granulosus infection) was evaluated in 27 hydatid patients divided into four clinical groups according to their response to albendazole/mebendazole therapy (full, partial, low and non-responders). After parasite antigen stimulation, peripheral blood mononuclear cells (PBMC) from full responders produced significantly more IFN-gamma (P=0.038), significantly less IL-4 (P=0.001) and less IL-10 than PBMC from non-responders. PBMC from partial and low responders produced intermediate cytokine concentrations. ELISA determining immunoglobulin production showed that sera from all non-responders had IgE and IgG4 antibodies, both regulated by IL-4. In contrast to IgG4, IgE decreased rapidly in full responders. Full responders also showed the highest percentage of IgG3 reactions. Qualitative analysis of total IgG responses in hydatid patients' sera determined by immunoblotting showed that binding profiles to hydatid cyst fluid antigen differed in the four groups of treated patients. Non-responders had the highest percentage of reactions to all subunits of antigens 5 and B, and full responders had the highest percentage of reactions to antigen 5 alone. The high IFN-gamma production associated with a lack of IL-4 and low IL-10 production in the full responders, and vice versa the high IL-4 and IL-10 production associated with lack of or low IFN-gamma production in the non-responders implies Th1 cell activation in protective immunity and Th2 cell activation in susceptibility to hydatid disease. IgE may be a useful marker of therapeutic success in hydatid patients with pretreatment specific IgE antibodies. IgG subclass responses and differential immunoglobulin subclass binding pattern to hydatid antigens may also be useful in the immunosurveillance of hydatid disease.