结核患者多功能CD8T细胞的表达水平及临床意义  

Expression level and clinical significance of multifunctional CD8 T cells of patients with tuberculosis

作　　者：刘先发[1] 黄才斌[1] 张明霞 邱振纲[1] 陈心春 何晓[1] 

机构地区：[1]赣南医学院第一附属医院,江西省赣州市341000 [2]第三人民医院深圳市感染免疫重点实验室,广东省深圳市518112

出　　处：《实用医学杂志》2014年第5期716-718,共3页The Journal of Practical Medicine

基　　金：国家自然科学基金项目(编号:81172732)

摘　　要：目的:探讨结核患者多功能CD8 T细胞的表达水平及其临床意义。方法:采用流式细胞术检测结核患者(TB)、潜伏感染者(LTBI)、健康对照(HC)外周血单个核细胞(PBMCs)或胸腔积液单个核细胞(PFMCs)结核特异性及非特异性多功能性CD8T细胞表达水平。结果 :非特异性抗原(PMA+I)刺激下,TB组PBMCs中多功能性CD8T细胞(IL-2+IFN-γ+TNF-α+CD8 T细胞)频率[(5.72±4.32)%]显著低于HC[(22.3±15.7)%(q=7.455,P<0.001)]和LTBI[(14.2±7.72)%,(q=3.110,P<0.05)];结核菌特异性抗原(MTB裂解液)刺激下,TB组PBMCs中多功能性CD8T细胞频率[(0.33±0.83)%]高于HC[(0.017±0.03)%(q=3.97,P<0.05)]和LTBI[(0.019±0.035)%,(q=3.39,P<0.05)];结核性胸膜炎患者PFMCs多功能CD8T细胞频率[(0.623±1.033)%]显著高于相应的PBMCs[(0.034±0.066)%,(P<0.001)];结核患者PBMCs多功能性CD8 T细胞表达水平和其HRCT评分呈负相关(r=-0.265 8,P=0.015 8)。结论:多功能CD8 T细胞表达水平检测有助于鉴别诊断结核患者和潜伏感染者,其与结核患者的病理损伤程度密切相关。Objective To explore the expression level and clinical significance of multifunctional CD8 T cells in patients with tuberculosis （TB）. Methods The expression levels of MTB antigen specific and non-specific multifunctional CD8 T cells among peripheral blood mononuclear cells （PBMCs） and pleural fluid mononuclear cells （PFMCs） in TB patients, latent tuberculosis infection patients （LTBI） and healthy controls （HC） were measured by flow cytometry. Results The expression level of muhifunctional CD8 T cells （IL-2 ＋ IFN-γ＋ TNF-α ＋ CD8 T cells） among PBMCs stimulated by non-specific MTB antigen in TB patients was （5.72± 4.32）%, which was significantly lower than those in HC and LTBI [ （22.3 ± 15.7）%, q = 7.455, P 〈 0.001 ; （14.2 ± 7.72）%, q = 3.110, P 〈 0.05 ]. Under the stimulation by specific MTB antigen, the expression level of muhifunctional CD8 T cells among PBMCs in TB patients was （0.33 ± 0.83）%, which was significantly higher than those in HC and LTBI [ （0.017 ± 0.03）%, q = 3.97, P 〈 0.05; （0.019± 0.035）%, q = 3.39, P 〈 0.05 ]. In patients with tuberculous pleurisy, the expression level of multifunctional CD8 T ceils among PFMCs was （0.623 ± 1.033）%, which was significantly higher than that among PBMCs [ （0.034 ± 0.066）%, P 〈 0.001 ]. The expression level of multifunctional CD8 T cells in TB patients was negatively correlated with HRCT score （r = -0.265 8, P = 0.015 8）. Conclusion The expression level of muhifunctional CD8 T cells was contributed to discriminate TB patients from latent tuberculosis infection patients, and was closely related to the degree of damage in lung.

关 键 词：结核 多功能CD8T细胞 抗原刺激 

分 类 号：R52[医药卫生—内科学]