| Objective:To use the PPD (purified protein derivatives tuberculin) test screening in children with asthma, who the PPD-negative to take in the experimental group to BCG (Bacillus Calmette-Guerin vaccine) vaccination, PPD stimulation as the interference factor. Comparing the clinical symptoms, T-cell subsets and CD4 + CD25 + regulatory T-cell changes between the experimental group and non-experimental group, so as to, providing a theoretical basis of the BCG and PPD at the prevention and treatment of bronchial asthma.Methods:There had been 68 asthmatic children with negative PPD test who are 5~14 years old collected from pediatric asthma clinic in our hospital, and were randomly divided into BCG / PPD intervention group (A group, 38, conventional treatment and to the BCG / PPD intervention) and non-intervention group (B group, 30, only conventional treatment), conventional therapy according to GINA (global initial for asthma). Take 10 healthy children as control group (C group). Before treatment (0 months) we had assessed the situation, grading according to GINA program, and made extraction of peripheral blood using flow cytometry T cell subsets and CD4 + CD25 + regulatory T-cell values. In addition to conventional treatment, the intervention group to be vaccinated BCG, one month after inoculation with the PPD skin test to determine the success of the monthly intradermal injection of PPD 5 units total in six months. Such as the PPD test is negative, determine the BCG is failed, then the BCG is re-vaccinated, after one month is given PPD test again, and so again, until the vaccination success or six months until the end of the study. non-intervention group was given routine treatment, observations were the same as intervention group. After three months and six months treatment assessed the control level of asthma respectively, and made extraction of peripheral blood using flow cytometry T cell subsets and CD4 + CD25 + regulatory T-cell values, partial control of the 9 cases, no control for 0 cases.Results:(1) after 3 months treatment: there have been 34 cases meet the standards in intervention group (A group),partial control in 8 cases, no control for 0 cases, there have been 21 cases achieved the control level in non-intervention group (B group), partial control of the 9 cases, no control for 0 cases. Comparison between the two groups, the intervention group received a few more cases which achieved clinical control, the difference was statistically significant (P <0.05).(2) after 6 months treatment: there have been 37 cases meet the standards in intervention group (A group), partial control in 1 cases, no control for 0 cases, there have been 23 cases achieved the control level in non-intervention group (B group), partial control of the 7 cases, no control for 0 cases, there were two more cases achieved the control level, the difference was statistically significant (P <0.05). Comparison between the two groups, the intervention group received more controlled cases than non-intervention group, the difference was statistically significant (P <0.05). (3) Pre-treatment T cell subsets and CD4 + CD25 + Treg test results: Compared with healthy group (C group), children with asthma, including the intervention group (A group) and non-intervention group (B group) , the complementary CD4 + T lymphocytes in the proportion of lymphocytes increased (P <0. 05); decline in CD8 + T cells, CD4 + / CD8 + ratio was significantly higher (P <0. 05), the proportion of CD4 + CD25 + Treg decreased (P <0. 05);(4) after six months treatment the T-cell subsets and CD4 CD25 regulatory T-cell test results: compared with pretherapy, the proportion of CD4 + T lymphocytes in lymphocytes of the intervention group (A group) decreased (P <0. 05), compared with the non-intervention group, the difference was not statistically significant (P> 0.05), CD8 + T lymphocytes increased compared with pretherapy(P <0. 05), compared with non-intervention group (B group), the difference was statistically significant (P <0.05), CD4 + / CD8 + ratio decreased significantly compared with pretherapy (P <0. 05), compared with the non-intervention group, the difference was not statistically significant (P> 0.05),the proportion of CD4 + CD25 + Treg was increased compared with pretherapy (P <0. 05), compared with non-intervention group (B group), the difference was statistically significant (P <0.05).Conclusions:(1) The pathogenesis of bronchial asthma have a certain relationship with the dysfunction of T cell subsets.(2) CD4 + CD25 + Treg reduction in the number may be an important reason leading to asthma.(3) BCG / PPD combination have a certain degree of preventive effect to asthma, the therapy can reduce the percentage of CD4 + cells, increase the percentage of CD8 + cells, Lower CD4 + / CD8 + cell ratio, increase the number of CD4 + CD25 + Treg. BCG / PPD combination therapy is more effective than single-use hormone therapy on asthma.
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