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脐血Treg细胞FOXP3 mRNA、IL-10和TGF-β对婴儿早期特应性皮炎的预测价值

Predictive value of FOXP3 mRNA, IL-10 and TGF-β in cord blood Tregs for early-onset atopic dermatitis in infants

    摘要
  • 摘要:
    目的 探讨脐血调节性T细胞（regulatory T cell, Treg）特异性转录因子叉头框转录因子P3（forkhead box P3, FOXP3）mRNA表达及细胞因子白细胞介素10（interleukin-10, IL-10）、转化生长因子β（transforming growth factor-β，TGF-β）水平对早期特应性皮炎（atopic dermatitis, AD）的预测价值。
    方法 选择2023年9月至2024年4月在复旦大学附属上海市第五人民医院健康顺产足月新生儿为研究对象，采集脐静脉血，采用RT-PCR检测FOXP3 mRNA表达水平，ELISA法测定IL-10和TGF-β浓度。通过电话或门诊随访婴儿生后6周、3个月、6个月时的AD发生情况。根据6个月时AD发生情况分为AD组与健康组，比较两组婴儿及母亲相关指标。采用logistic回归分析筛选婴儿早期（出生后6个月内）发生AD的危险因素，构建预测模型。采用ROC曲线分析模型预测婴儿早期发生AD的效能。
    结果 共纳入59例完成6个月随访的婴儿，AD发生率为28.8%（17/59）。两组胎龄、性别、出生体质量、有无兄弟姐妹、被动吸烟史、母亲孕期饮食偏好（鸡蛋、牛奶或海鲜摄入）、母亲年龄及教育水平、脐血IL-10水平等差异无统计学意义。两组出生季节、特应性疾病家族史、喂养方式、脐血FOXP3 mRNA水平及TGF-β水平等差异有统计学意义（P＜0.05）。Logistic回归分析显示，低水平脐血FOXP3 mRNA、低水平脐血TGF-β、有特应性疾病家族史是婴儿早期发生AD的独立危险因素（P＜0.05）。将危险因素作为预测因子构建预测模型。联合模型预测新生儿发生AD的曲线下面积为0.821，95%CI 0.680～0.962，灵敏度76.5%，特异度85.7%。
    结论 脐血FOXP3 mRNA、TGF-β低表达及有特应性家族史可用于预测婴儿早期AD发生风险。

     

    Abstract:
    Objective To explore the predictive value of forkhead box P3 (FOXP3) mRNA expression in cord blood derived regulatory T cells (Tregs) and the associated cytokines interleukin-10 (IL-10) and transforming growth factor-β (TGF-β) for early-onset atopic dermatitis (AD) in infants.
    Methods  The healthy full-term newborns delivered vaginally at Shanghai Fifth People’s Hospital from September 2023 to April 2024 were enrolled. Umbilical vein blood was collected at birth to measure FOXP3 mRNA expression by RT-PCR and IL-10 and TGF-β concentrations by ELISA. Follow-up was performed at 6 weeks, 3 months, and 6 months postnatally via telephone or outpatient visits to assess the occurrence of AD in infants. Based on the occurrence of AD at 6 months of age, the infants were divided into an AD group and a control group. The indicators related to mothers and infants were compared between the two groups. Logistic regression analysis was used to identify risk factors for the development of AD in infants within 6 months after birth, and a predictive model was constructed. The performance of the model in predicting early-onset AD was evaluated using receiver operating characteristic (ROC) curve analysis.
    Results A total of 59 infants completed 6-month follow-up, with 17 (28.8%) diagnosed with AD. No significant differences were observed in gestational age, sex, birth weight, presence of siblings, smoking expossure, maternal dietary preferences (egg, milk, or seafood intake), maternal age and education level, or cord blood IL-10 levels between two groups. There were significant differences in season of birth, family history of atopic disease, feeding method, and cord blood levels of FOXP3 mRNA and TGF-β between two groups (P＜0.05). Logistic regression analysis showed low levels of cord blood FOXP3 mRNA and TGF-β, and family history of atopic disease were risk factors for early-onset AD in infants (P＜0.05). A predictive model was constructed using risk factors. The area under the curve of the combined model was 0.821 (95%CI 0.680–0.962), with a sensitivity of 76.5% and a specificity of 85.7%.
    Conclusion Reduced cord blood FOXP3 mRNA and TGF-β level, and a family history of atopic diseases could be used to predict early-onset AD in infants.

     

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