肺结核患者结核分支杆菌EIS抗原特异性细胞免疫的临床研究  

Study on specific cellular immunity of enhance intracellular survival antigen of mycobacterium tuberculosis in patients with pulmonary tuberculosis

作　　者：王火生[1] 陈心春[1] 李美忠[1] 张维[1] 邓群益[1] 付向东[1] 张红梅[1] 王辉[1] 周伯平[1] 

机构地区：[1]深圳市东湖医院,518020

出　　处：《中国危重病急救医学》2006年第8期498-500,共3页Chinese Critical Care Medicine

基　　金：广东省深圳市科技计划项目(200304204)

摘　　要：目的探讨肺结核患者结核分支杆菌EIS抗原特异性细胞免疫水平与病情的关系。方法选择30例初治、痰涂片结核杆菌阳性的活动性肺结核患者,采用比色法测定其外周血淋巴细胞对结核分支杆菌EIS抗原的增殖反应,酶联免疫吸附法测定细胞分泌的γ干扰素(IFNγ)及白细胞介素10(IL10)的水平,并与20名健康对照者和16例康复的肺结核患者进行比较。结果康复者对EIS的细胞免疫最为强烈,其外周血淋巴细胞的细胞增殖强度显著高于健康对照者和活动性肺结核患者(P均<0.01)。活动性肺结核患者外周血淋巴细胞在受到EIS刺激时分泌的IFNγ显著低于康复者(P<0.05)。EIS抗原刺激主要诱导细胞分泌Th2型细胞因子IL10。结论活动性肺结核患者对EIS抗原的细胞免疫水平低下,经抗结核治疗康复后,细胞免疫维持在较高水平。EIS抗原诱导Th1/Th2免疫失衡可能是EIS参与结核发病的机制之一。Objective To investigate the level of specific cellular immunity in patients with active pulmonary tuberculosis and its potential relationship with severity of the disease. Methods Thirty active pulmonary tuberculosis patients with positive tubercle bacilli in sputum were enrolled for the study. Immune responses including lymphocytes proliferation enhanced by enhance intracellular survival （EIS） antigen and cytokine production including interferon -γ （IFN - γ） and interleukin - 10 （IL - 10）, were assayed. Cell proliferation was determined by methyl thiazolyl tetrazolium （MTT）, while cytokine production was quantified by enzyme-linked immunoadsorbent assay （ELISA）. The results were compared to those of 20 healthy individuals and 16 persons recovered from tuberculosis. Results Cell proliferation response and IFN - γ production were significantly higher in patients convalescent from tuberculosis compared to patients with active pulmonary tuberculosis, EIS antigen was found to elicit a dominant Th2 cytokine response. Conclusion Impaired Thl immune response to EIS is observed in patients with active pulmonary tuberculosis. Induction of imbalance of Th1/Th2 immune response may be the main action of EIS, which may be a factor of pathogenesis of tuberculosis.

关 键 词：肺结核 细胞免疫 EIS蛋白 

分 类 号：R521[医药卫生—内科学]