氣喘是一種孩童常見的慢性呼吸道發炎性疾病。吸入過敏原，如家庭塵螨後，經由E 型免疫球蛋白的調控的過敏反應，而產生支氣管收縮。呼吸道的T淋巴球、嗜酸性白血球、巨噬細胞以及肥胖細胞浸潤現象，是一項重要的臨床特徵。在不同族群的一些基因關聯性研究中已在各種不同的染色體上找到一些位置與氣喘或是過敏性疾病的發生有著密切的關係，5號染色體長臂31(5q31)的位置是其中之一。位於這段區域的基因與血清中的E型免疫球蛋白的濃度與嗜酸性白血球的濃度有密切的關係。此外，此區域也包括了一些基因如細胞間質-4、細胞間質-5、細胞間質-13、CD14 和 granulocyte macrophage colony-stimulating factor等。這些基因所表達的蛋白質與T淋巴球的成熟和分化有關係。曾有研究發現，soluble CD14在一些發炎性疾病中有增加的趨勢，而且它與血液中的E 型免疫球蛋白的濃度成反比。但是，同樣是屬於發炎性疾病，過敏性氣喘病人血液中的soluble CD14的濃度就比較低。此外，也有研究發現CD14基因上相對於轉錄起始點的-159位置若有C -> T 的變異，則會影響啟動子的轉錄活性。有關於CD14基因型與疾病的相關性一直都是大家研究的主題。但是卻出現了兩極的結論，以氣喘為例，A. Heinzmann 的研究團隊發現在高加索的小孩的CD14基因型與氣喘沒有相關性，但是, 卻有其他的研究團隊指出患有過敏性疾病的小孩若是帶有CD14/-159CC 的話，則他們血清中的E 型免疫球蛋白濃度比較高。可是,與其他實驗合作的研究中發現，-159 的基因型與血清中的E 型免疫球蛋白濃度並沒有相關性，除非加入另一個marker。除了 CD14/-159這個基因型外,也有找到其他的基因型。而其中有兩個基因型 (-1145 和 -1359) 也常被研究。去年的一篇研究中有提到-159 和 -1359 這兩個基因型與由E 型免疫球蛋白所調控的過敏性疾病有關。由於CD14的基因型與過敏性氣喘之前的相關性一直呈現不同的結論，所以懷疑它們之間的相關性是由造成過敏性氣喘的其中之一的過敏原所影響的。在常見的過敏原中，家庭塵螨是最常見的。目前已知造成過敏的是它們的排泄物和一些消化酵素。為了了解家庭塵螨過敏原是否與CD14的基因型有關係，首先我們利用了酵素免疫分析法證明了家庭塵螨過敏原會與CD14 結合。接著，收集240個檢體，依據臨床診斷和過敏原測試結果，把他們區分為4個不同的族群，分別是 1. 過敏性氣喘(N=60人)、2.非過敏性氣喘(N=60人)、3. 過敏性但是不具有氣喘(N=60人)和4.不過敏也沒有氣喘的個體(N=60人)。比較氣喘組與對照組或是對家庭塵螨過敏組與對照組的soluble CD14 的濃度的差異，結果發現soluble CD14的濃度分佈在對家庭塵螨過敏組與對照組有差異‧在知道每個檢體的CD14基因型後，首先先比較不同基因型的CD14與血清中的soluble CD14和E 型免疫球蛋白的濃度是否有差異。所得到的結果是，帶有CD14/-1359TT的個體，他們的soluble CD14的濃度明顯的比帶有GG或是GT基因型的個體低。相對的他們的E 型免疫球蛋白的濃度則比較高。若比較氣喘組與對照組或是對家庭塵螨過敏組與對照組的基因型分佈是否有差異，則發現說只有在-1359這個基因型，它們在對家庭塵螨過敏組與對照組的分佈有差異，p値小於0.05，所以判定CD14/-1359與家庭塵螨過敏原有相關性。利用PopGene和 PyPop 這個軟體，證明這三個基因型彼此之間具有相連性。所以，進一步評估這些位置的交互作用是否會影響血清中的soluble CD14和E 型免疫球蛋白的濃度。粗略的結果中可以看到帶有CD14 -159CC/-1145AA/-1359TT 則他們血清中的soluble CD14濃度比較低而E 型免疫球蛋白的濃度比較高，相反的，若是帶有CD14 -159TT/-1145GG/-1359GG 則結果與CD14 -159CC/-1145AA/-1359TT 是相反的。總而言之，我們認為CD14 的基因型與家庭塵螨過敏原有相關性。

　　Asthma is a chronic inflammatory disease which is commonly seen among the children. After exhale the allergens, such as house dust mite, the bronchiole is contracting and is mediated by the immunoglobulin E. The infiltration of the T-lymphocytes, eosinophils, macrophages and mast cells in the respiratory tract is an important clinical syndrome. Searching through different populations, multiple loci located on different chromosome are found to be associated with the asthma or allergic disease, for example chromosome 5q31. The genes within 5q31 are interleukin-4’s gene, interleukin-5’s gene, interleukin-13’s gene, CD14’s gene, granulocyte macrophage colony-stimulating factor’s gene and other genes. They are involved with the maturation and differentiation of the T –lymphocytes. The recent researches had shown that the increased levels of soluble CD14 were found in the inflammatory disease and inverse correlated with the total serum IgE concentrations. Despite that asthma is an inflammatory disease, the soluble CD14 levels among the asthmatics individuals are comparatively lower than non-asthmatics individuals. Besides that, the CD14/-159 C->T mutations had shown would affect the transcriptional activity of the genes. The associations between the CD14 genotype and diseases are frequently studied. However there are always show contradictory results. For example, A.Heinzmann and his colleagues found no associations between the CD14 genotype and asthma among the Caucassian children while the other groups pointed out that the total serum IgE concentration were higher in the individuals with CD14/-159 CC homozygous. Our previous data , which cooperated with other lab, showed no associations between the CD14/-159 and total serum IgE levels. Besides CD14/-159, other polymorphism sites were found. Among the identified polymorphism sites of CD14, CD14/-1145 and CD14/-1359 were frequently studies.In 2003, a published paper mentioned that CD14/-159 and CD14/-1359 were associated with allergic diseases which were mediated by the immunoglobulin E. Due to the contradicted results of the associations between CD14 genotype and asthma, we were strongly suspected that the associations are affected by the allergens. House dust mites are the major allergens who leading to the pathogenesis of asthma. Its fecal waste and the digestive enzymes are believed to be the major allergens. In order to determine the associations between the mite allergens and CD14 genotype, we first used the ELISA method to show that CD14 would bind with dust mite allergens. Later on, 240 individuals were collected and divided into 4 groups based on their clinical syndrome and the allergens’ test. These 4 groups were : 1.allergic asthma (N=60), 2. non-allergic asthma (N=60), 3. allergic without CD14 syndrome (N=60) and 4. non-allergic and non-asthma (N=60). Compare the distribution of soluble CD14 levels between the asthmatic and non-asthmatic individuals or mite-sensitized and non-mite sensitized individuals, we noticed there was no significant differences between the asthmatic and non-asthmatic individuals but significant differences between the mite-sensitized and non-mite sensitized individuals. After identified their genotypes, we compared the distribution of CD14 levels and total serum IgE levels among the different genotypes. As the result, the CD14/-1359 TT individuals were found to have higher concentration of the soluble CD14 and lower total serum IgE levels than CD14/-1359 GG or GT . If we compared the distribution of the genotypes between the asthmatics and non-asthmatics or mite-sensitized and non-mite sensitized individuals, we observed that it is significant differences between the CD14/-1359 and the mite-sensitization and the p value was below 0.05, therefore we could conclude that the CD14/-1359 was associated with the mite-sensitization. Using the PopGene and PyPop programs, we proved that these three polymorphism sites were in linkage disequilibrium. Therefore, it was necessary to evaluate the effect of the collaboration of CD14/-159, -1145 and -1359 towards the concentrations of the soluble CD14 and immunoglobulin E levels in the serum. Roughly, we showed that those carriers with CD14 -159CC/-1145AA/-1359TT were comparatively with lower soluble CD14 levels and higher total serum IgE levels compared to CD14 -159TT/-1145GG/-1359GG. Therefore, we suggest that CD14 genotypes were associated with the mite-sensitization.

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