抗结核治疗对结核患者Th17细胞及调节性T细胞平衡状态的影响  

Influence of Antituberculosis Therapy on Balanced State of Th17 Cells and Regulatory T Cells in Patients with Tuberculosis

作　　者：余元华[1] 王永慧[1] 熊晓红[1] 

机构地区：[1]湖北医药学院附属太和医院防保感控处,十堰442000

出　　处：《成都医学院学报》2013年第3期305-307,共3页Journal of Chengdu Medical College

基　　金：中国高校医学期刊临床专项资金项目(NO:11320105)

摘　　要：目的探讨抗结核治疗对肺结核患者Th17细胞(CD3、CD4、IL-17T细胞)以及调节性T细胞(CD4、CD25、Foxp3T,Tr)平衡状态的影响。方法选取肺结核患者40例为研究对象,同时选取40例自愿参与研究的健康志愿者为对照组,分别于治疗0、3、6个月等时段采用流式细胞术测定受试者血液中Th17/Tr,并对其相关性进行分析。同时采用r-干扰素、IL-6、IL-1β、IL-12对Th17细胞进行分化,以了解Th17/Tr在肺结核患者失衡的机制。结果肺结核患者在抗结核治疗6个月后Tr细胞在CD4T细胞中的比例显著低于治疗前以及治疗后3个月,但仍显著高于对照组。肺结核患者在抗结核治疗6个月后Th17细胞在CD4T细胞中的比例显著高于治疗前以及治疗后3个月,但仍显著低于对照组。单用IL-6、IL-1β或2者联合治疗能促使CD4T细胞向Th17细胞分化,而用r-干扰素、IL-12则能抑制IL-6、IL-1β对Th17细胞的分化作用。结论结核分枝杆菌是导致Tr细胞及Th17细胞失衡的重要原因,细胞因子IL-6、IL-1β可促进结核患者Th17细胞分化,逐渐恢复Th17/Tr平衡状态。Objective To investigate the influence of antituberculosis therapy on balaneed state of Th17 cells （CD3 ,CD4, IL-17T cells） and regulatory T cells （CD4 ,CD25, Foxp3T,Tr） in patients with tuberculosis. Methods 40 patients with tuberculosis and 40 healthy volunteers were selected as treatment group and control group, respectively. Th17/Tr in blood of two groups was determined using flow eytometry （FCM） at the time of 0,3,6 months. Then,Th17/Tr cells were differentiated by r-interferon,IL-6,IL-1β and IL-12 to find out the pathogenesis of ThlT/Tr imbalance in patients with tuberculosis. Results 6 months after treatment,the proportion of Tr cells in CD4T cells in treatment group was evidently lower than treatment before and 3 months after treatment, but still higher than that in control group. Whereas the Thl7 cells displayed in an opposite way to the Tr cells. Both single or combined application of IL-6 and IL-1β could improve the differentiation of CD4T cells to Thl7 cells, which was inhibited by r-interferon and IL-12. Conclusion Mycobacterium tuberculosis is an important risk to lead to the imbalance of Tr and Thl7 cells, and IL-6 and IL-1β can promote the differentiation of Thl7 cells in patients with tuberculosis and thus help to regain its balanced state.

关 键 词：肺结核 抗结核治疗 TH17细胞 TR细胞 

分 类 号：R521[医药卫生—内科学] R392.12[医药卫生—临床医学]