川崎病患儿树突状细胞亚群变化及意义初探

doi:10.12372/jcp.2022.21e1680

Abstract

Abstract:

Objective To investigate the changes of dendritic cell (DC) subsets in children with acute Kawasaki disease (KD) and their significance. Methods The clinical data of children with initial acute KD from December 2020 to May 2021 were retrospectively analyzed. Blood samples of KD children were taken before and after intravenous immunoglobulin (IVIG) treatment. Flow cytometry was used to detect the number and proportion of DC subgroup plasmacytoid dendritic cells (pDC) and CD1c⁺ myeloid dendritic cells (mDC) in peripheral blood as well as the expression levels of human leucocyte antigen-DR (HLA-DR), CD86 and CD40 proteins. Children who underwent physical examination at the same period were selected as the control group. Results There were 32 children (19 boys and 13 girls) in the KD group, and the median age was 37.0 (22.3-58.5) months. In the control group, there were 23 children (14 boys and 9 girls) and the median age was 52.0 (30.0-65.0) months. The proportion of pDC and CD1c⁺mDC in peripheral blood DCs before and after IVIG treatment in KD group was lower than that in control group, and the proportion of CD1c⁺mDC in peripheral blood DCs after treatment was higher than that before treatment. The number of pDC and CD1c⁺mDC in pre-treatment group was lower than that in control group and post-treatment group, and the differences were statistically significant (P<0.05). The expression levels of CD86 and CD40 on pDC surface and the expression levels of HLA-DR and CD86 on CD1c⁺mDC surface were lower than those in control group and post-treatment group, with statistical significance (P<0.05). The number of pDC and CD1c⁺mDC in KD children in acute stage was significantly negatively correlated with c-reactive protein and neutrophil to lymphocyte ratio (P<0.05). The number of CD1c⁺mDC was also negatively correlated with ESR (P<0.05). Conclusions The number of pDC and CD1c⁺mDC in peripheral blood circulation of KD children was insufficient and their function was impaired. Circulating pDC and CD1c⁺mDC may be involved in the immunological pathogenesis of KD.

Key words: Kawasaki disease, dendritic cell, antigen-presenting molecule, costimulatory molecule

WANG Nana, MENG Lijun, ZHANG Qianwen, ZHANG Fan, HOU Miao, CHEN Ye, WANG Bo, YAN Wenhua, LYU Haitao, SUN Ling, HUANG Jie. Changes and significance of dendritic cell subsets in children with Kawasaki disease[J].Journal of Clinical Pediatrics, 2022, 40(7): 500-504.

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组别	例数	pDC/%	CD1c⁺mDC/%	pDC/个·mL^-1	CD1c⁺mDC/个·mL^-1
对照组	23	46.8(34.1~58.2)	33.3(26.6~40.5)	19 032.0(14 296.0~28 642.0)	14 592.0(8 889.0~18 059.0)
治疗前组	32	26.3(16.0~39.6)¹⁾	10.1(7.4~17.8)¹⁾	9 449.0(4 821.0~22 561.0)¹⁾	4 747.0(2 245.0~6 628.0)¹⁾
治疗后组	32	33.1(26.8~41.5)¹⁾	17.9(13.9~27.0)¹⁾²⁾	19 307.0(11 632.0~26 346.0)²⁾	10 604.0(6 488.0~149 650.0)²⁾
H值		16.66	26.53	11.36	22.91
P		<0.001	<0.001	0.003	<0.001

组别	例数	pDC			CD1c⁺ mDC
组别	例数	HLA-DR	CD86	CD40	HLA-DR	CD86	CD40
对照组	23	15 057.0 (12 398.0~18 301.0)	295.0 (224.0~397.0)	488.0 (376.0~725.0)	24 552.0 (18 513.0~28 455.0)	1 459.0 (1 389.0~1 576.0)	297.0 (247.0~389.0)
治疗前组	32	14 384.0 (9 243.0~18 244.0)	213.0 (142.0~258.0)¹⁾	275.0 (248.0~403.0)¹⁾	17 583.0 (13 912.0~22 127.0)¹⁾	885.0 (825.0~1 074.0)¹⁾	328.0 (276.0~477.0)
治疗后组	32	15 249.0 (12 303.0~18 505.0)	262.0 (184.0~344.0)²⁾	457.0 (326.0~529.0)²⁾	22 624.0 (17 504.0~27 877.0)²⁾	1 123.0 (965.0~1 342.0)¹⁾²⁾	343.0 (252.0~474.0)
H值		1.17	10.16	21.15	13.42	42.18	3.28
P		0.559	0.006	<0.001	0.001	<0.001	0.195

Changes and significance of dendritic cell subsets in children with Kawasaki disease

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