程序性死亡分子-1及其配体在肺结核患者外周血淋巴细胞表面的表达  

Expressions of programmed death-1 and programmed death ligand on the surface of peripheral bloodlymphocytes in patients with tuberculosis

作　　者：胥萍[1] 陈永井[2] 陈慧[1] 朱晓燕[1] 吴敏娟[1] 张学光[2] 

机构地区：[1]苏州市第五人民医院中心实验室,215007 [2]苏州大学医学生物技术研究所,215007

出　　处：《中华传染病杂志》2014年第3期150-153,共4页Chinese Journal of Infectious Diseases

基　　金：苏州市科学技术局资助项目（SS0527、SYS201155）;江苏省卫生厅资助项目（KF200974）

摘　　要：目的了解肺结核患者外周血淋巴细胞表面程序性死亡分子-1（PD-1）及其配体（PD-L1）表达的特性。方法以肺结核患者27例，肺结核合并细菌或真菌感染41例，肺结核合并糖尿病患者9例，健康对照者29名作为研究对象。应用流式细胞术检测研究对象外周血淋巴细胞和单核细胞表面PD-1／PD-L1的表达水平，两样本均数比较采用t检验。结果肺结核、肺结核合并感染及肺结核合并糖尿病患者外周血中CD4＋CD25＋T淋巴细胞、CD4＋CD25＋曲T淋巴细胞均明显高于健康对照者（t值分别为4．892、4．635、4．974，5．407、4．660和5．279；均P〈0．01）；且CD8＋T淋巴细胞表面均高表达PD-1，与健康对照者相比，差异有统计学意义（t值分别为6．392、8．249和7．072，均P〈0．01）。肺结核、肺结核合并感染及肺结核合并糖尿病患者外周血单核细胞表面PD-L1的表达量分别为（42．51土7．54）％、（49．42±6．29）％和（48．46±14．58）％，与健康对照者（17．91±3．03）％相比，差异有统计学意义（￡值分别为5．168、6．854和5．665，均P〈0．01）；外周血B淋巴细胞表面PD-L1的表达量分别为（51．51±7．32）％、（50．85±7．09）％和（55．66土14．29）％，与健康对照者（40．u±4．25）％相比，差异有统计学意义（f值分别为2．562、2．046和2．766，均P〈0．05）。结论PD-1／PD-L1抑制途径可能与肺结核及其合并症的发生密切相关，参与调节减弱抗结核与抗感染免疫反应过程。Objective To describe the expressions of programmed death-1 （PD-1） and its ligand PD-L1 on the surface of peripheral blood lymphocytes in patients with tuberculosis. Methods A total of 77 cases of pulmonary tuberculosis were recruited, of which 27 were single infection, 41 were coincident with bacterial or fungal infection and 9 patients with diabetes mellitus. Twenty-nine healthy donors were also enrolled as control group. The expressions of PD-1/PD-L1 on the peripheral blood lymphoeytes and mononuclear cells were detected using immunostaining and flow cytometry. Collected data were analyzed with t test statistics. Results Among the three groups of tuberculosis including pulmonary tuberculosis, pulmonary tuberculosis coincident with infection and pulmonary tuberculosis with diabetes mellitus, the percentages of CD4＋ CD25＋ T cells as well as CD4＋ CD25high T cell subsets were both significantly higher than those in healthy controls （t=4. 892, 4. 635, 4. 974, 5. 407, 4. 660, 5. 279, all P〈0. 01）. The expression of PD-1 was up-regulated on the surface of CD8＋ T cells in the groups of tuberculosis as compared with the control group （t=6. 392, 8. 249, 7. 072, all P〈0.01）. The proportions of PD-L1 expressed on the monocytes in each group were （42. 51 ± 7. 54）0/00, （49. 42±6. 29）%and （48. 46 4± 14.58）% , respectively. The difference was significant in contrast to the control group, which was（17.91±3.03）% （t=5. 168, 6. 854, 5. 665, all P〈0.01）. PD-L1 expression was also up-regulated on B cells in each group and much higher than that of the control group （51.51 ± 7.32）%, （50.85± 7.09）% （55.66±14.29）% vs （40.11±4.25）%（t=2.562, 2.046, 2.766, all P〈0.05）. Conclusion PD-1/ PD-L1 co-inhibitory pathway could be closely related to the development of tuberculosis and its complications, which is involved in the attenuation of anti-tuberculosis and anti-infection immune responses.

关 键 词：结核 肺 配体 CD8阳性T淋巴细胞 细胞凋亡 CD4阳性T淋巴细胞 

分 类 号：R521[医药卫生—内科学]