日本血吸虫感染经吡喹酮治疗后血清中抗体及细胞因子水平的变化

目的：观察人感染日本血吸虫经吡喹酮治疗后血清中可溶性虫卵抗原（SEA）特异性抗体IgG、IgM及IL-4、IFN-γ水平的变化，并观察治疗后外周血中SEA特异性分泌IFN-γ的淋巴细胞数量的变化。方法：阳性组血清采自湖北省江陵市荆州县粪检血吸虫虫卵阳性患者15例，治疗组血清采自当地吡喹酮治疗8个月后3次粪检虫卵阴性者15例，阴性组血清采自当地的健康人群15例。通过ELISA的方法检测血清中SEA特异性IgG、IgM抗体及IL-4、IFN-γ的水平。取各组样本中3例进行ELISPOT实验，检测外周血中SEA特异性IFN-γ淋巴细胞数量。结果：ELISA结果表明，血清中SEA特异性IgG、IgM治疗组与阳性组相比显著性降低，且治疗组、阳性组均显著高于阴性组（P<0.05）；血清中IL-4、IFN-γ水平治疗组比阳性组显著性降低（P<0.05）。ELISPOT实验结果显示外周血中SEA特异性分泌IFN-γ淋巴细胞数量阳性组显著高于治疗组及阴性组（P<0.05），而治疗组与阴性组之间的差异不具显著性（P>0.05）。结论：血清中IL-4、IFN-γ水平及外周血中IFN-γ淋巴细胞数量的检测可以用于吡喹酮治疗血吸虫感染疗效的考核，而血清中IgG、IgM水平变化对于吡喹酮疗效的考核也具有一定的辅助作用。

Objective: To detect the levels of soluble egg antigen (SEA)-specific antibodies IgG,IgM,IL-4 and IFN-γ in serum,and the counts of IFN-γ lymphocyte in peripheral blood of people infected with Schistosoma japonicum after praziquantel treatment. Methods: Serum in the positive group were collected from 15 stool egg-positive patients with schistosomiasis in Jiangling County of Jingzhou City,Hubei Province,and serum in the treatment group were collected from 15 stool egg-negative patients with schistosomiasis treated with praziquantel for 8 months,and negative serum from 15 local healthy people.The levels of SEA-specific IgG,IgM and IL-4,IFN-γ in serum were detected by ELISA.Three cases of each group were selected to detect the count of SEA-specific IFN-γ lymphocytes in peripheral blood by ELISPOT. Results: ELISA results showed that the levels of SEA-specific serum IgG,IgM in the treatment group decreased significantly compared with the positive group,and the levels in the treatment group and the positive group were significantly higher than that in the negative group (P<0.05).While the levels of IL-4 and IFN-γ in serum of treatment group significantly decreased compared with the positive group (P<0.05).ELISPOT results showed that,compared with positive group,the counts of SEA-specific IFN-γ lymphocytes in peripheral blood of treatment and negative groups were significantly lower(P<0.05),while there was no significant difference between the treatment group and the negative group (P>0.05). Conclusion: The various levels of IL-4,IFN-γ in serum and SEA-specific IFN-γ lymphocytes in peripheral blood can be used to assess the efficacy of praziquantel treatment for schistosomiasis infection.In addition,the levels of IgG,IgM in serum have a supporting role in the efficacy assessment of praziquantel.