哮喘联盟

   摘要
   背景和目的：妊娠期严重哮喘发作是一个常见并发症，导致母亲和婴儿的健康转归均较差。哮喘发作常常由呼吸道病毒感染所导致。妊娠期抗病毒和炎症性免疫反应之间的平衡至关重要，而哮喘和呼吸道病毒感染可使该平衡发生改变。
   方法：收集（1）非妊娠健康对照者；（2）妊娠无哮喘者；（3）产后无哮喘者；（4）无妊娠哮喘患者；（5）妊娠哮喘患者和（6）产后哮喘患者的外周血单核细胞（PBMCs）。采用有丝分裂原植物血凝素或2009年流行的猪流感病毒株刺激体外培养的这些细胞。检测培养液中的γ-干扰素、IL-10和IL-17蛋白表达。检测妊娠和产后女性的中性粒细胞数。
   结果：植物血凝素刺激外周血单核细胞后，与健康非妊娠女性相比，妊娠哮喘患者的IL-17显著增加，IFN-γ显著下降。流感病毒感染后，妊娠期哮喘患者的IFN-γ和IL-10产生显著下降。植物血凝素刺激后的IL-17含量与中性粒细胞百分数相关。IFN-γ、IL-10和IL-17的差异至少持续至产后6个月。
   结论：妊娠期哮喘女性的外周血单核细胞、抗病毒和调节性免疫下降，而炎症反应增加。该效应与妊娠期呼吸道病毒感染的易感性和疾病严重程度增加有关。
 

（刘国梁 审校）
Respirology. 2013 Feb 20. doi: 10.1111/resp.12068. [Epub ahead of print]
 

Alterations in Inflammatory, Antiviral and Regulatory Cytokine Responses in Peripheral Blood Mononuclear Cells from Pregnant Women with Asthma.

Vanders RL, Gibson PG, Wark PA, Murphy VE.

Source
Centre for Asthma and Respiratory Diseases, School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW, Australia; Hunter Medical Research Institute, Newcastle, NSW, Australia.

Abstract
BACKGROUND & OBJECTIVE: Severe asthma exacerbations during pregnancy are a common complication leading to poor health outcomes for both mother and baby. Asthma exacerbations are caused most frequently by respiratory viruses. A balance between antiviral and inflammatory immune responses is critical during pregnancy: the balance may be altered by asthma and respiratory virus infection.
METHODS: Peripheral blood mononuclear cells (PBMCs) were isolated from (1) non-pregnant healthy controls, (2) pregnant non-asthmatics, (3) postpartum non-asthmatics, (4) non-pregnant asthmatics (5) pregnant asthmatics, and (6) postpartum asthmatics. Cells were cultured in vitro with the mitogen phytohaemagglutinin or with a strain of the 2009 pandemic swine influenza. Interferon-γ, interleukin-10, and interleukin-17 protein were measured from culture supernatant. Neutrophil counts were obtained in samples from pregnant and postpartum women.
RESULTS: Following phytohaemagglutinin stimulation of peripheral blood mononuclear cells, pregnant asthmatics had significantly higher IL17 and significantly lower IFNγ responses compared to healthy non-pregnant women. Following infection with influenza, a significant reduction was also observed in interferon-γ and interleukin-10 production from PBMCs of pregnant asthmatics. The interleukin-17 response to phytohaemagglutinin correlated with the neutrophil percentage. Differences in interferon-γ interleukin-10 and interleukin-17 were found to persist for at least 6 months postpartum.
CONCLUSIONS: A reduction in anti-viral and regulatory immunity with increased inflammation during pregnancy occurs in peripheral blood mononuclear cells from pregnant women with asthma. This novel information may relate to the increased susceptibility and disease severity to respiratory virus infections observed during pregnancy.
 

Respirology. 2013 Feb 20. doi: 10.1111/resp.12068. [Epub ahead of print]