从Th17和CD4^+CD25^+Foxp3^+T细胞功能变化探讨肺结核的耐药机制  

Investigation on resistance mechanisms of tuberculosis though the function changes of Th17 cell and CD4^+ CD25^+ Foxp3^+ regulatory T cells

作　　者：宋群[1] 王新霞[1] 童照威[1] 

机构地区：[1]湖州市中心医院感染科,浙江湖州313000

出　　处：《中华全科医学》2016年第12期2023-2026,共4页Chinese Journal of General Practice

基　　金：浙江省湖州市科技局项目(2014GZ10)

摘　　要：目的分析耐药肺结核患者外周血Th17细胞与CD4^+CD25^+Foxp3^+T细胞比例及细胞因子的变化,从免疫学角度探讨其耐药机制。方法分别选取33例耐药肺结核(耐药组)、49例普通肺结核(普通组)及51例健康志愿者(对照组)展开对比研究。检测Th17细胞与CD4^+CD25^+Foxp3^+T细胞比例;采用RT-PCR检测其特异性转录因子RORγt与Foxp3的mRNA表达水平;采用ELISA实验检测IL-17A、IL-17F、TGF-β1及IL-10的血清水平。结果普通组Th17细胞比例和RORγt mRNA表达水平低于对照组,耐药组低于普通组;普通组CD4^+CD25^+Foxp3^+T细胞比例和Foxp3 mRNA表达水平高于对照组,耐药组高于普通组;普通组Th17/CD4^+CD25^+Foxp3^+T和RORγt/Foxp3低于对照组,耐药组低于普通组(P<0.05)。普通组IL-17A、IL-17F水平低于对照组,耐药组低于普通组;普通组TGF-β1、IL-10水平高于对照组,耐药组高于普通组;其组间差异均有统计学意义(P<0.05)。结论 Th17/CD4^+CD25^+Foxp3^+T平衡向CD4^+CD25^+Foxp3^+T偏移、免疫系统功能抑制,可能是结核病慢性化和产生耐药的重要机制之一。Objective To analyze the changes of Th17 cells,CD4＋ CD25＋ Foxp3＋ regulatory T（Treg） cells,and cells cytokines in peripheral blood of tuberculosis patients with drug-resistant, and investigate the resistance mechanism though immunological point. Methods Thirty-there cases of drug-resistant tuberculosis patients （resistance group） ,49 eases of ordinary TB（ general group）, and 51 healthy volunteers （control group）were selected and comparative studied. The Th17 cells and CD4＋ CD25＋ Foxp3＋ Treg cells ratio were detected. The expression of specific transcription factors RORγt and mRNA in Foxp3 were detected by RT-PCR. The serum IL-17A, IL-17F, TGF-β1 and IL-10 levels were detected by ELISA. Results The Th17 cells ratio and RORγt mRNA expression of normal group were lower than the control group, and resistance group were lower than the normal group ; The CD4＋ CD25 ＋ Foxp3 ＋ Treg ceils ratio and Foxp3 mRNA expression were higher than the control group, and resistance group were higher than normal group;The Th17/CD4＋ CD25＋ Foxp3＋ Treg cells and RORγt/Foxp3 of normal group were lower than the control group, and resistance group were lower than normal group（P 〈 0.05 ）. IL-17A and IL-17F levels of normal group were lower than control group, and resistance group were lower than normal group. The TGF-β1 and IL-10 levels were higher than control group, and resistance group were higher than normal group（ P 〈 0.05 ）. Conclusion The balance offset of Th17/ CD4＋ CD25 ＋ Foxp3 ＋ Treg cell to CD4 ＋ CD25 ＋ Foxp3＋ Treg cell and immune system suppression might be one of important mechanism of chronic and pro- duce resistant in tuberculosis.

关 键 词：肺结核 TH17细胞 CD4+CD25+Foxp3+T细胞 耐药机制 

分 类 号：R521[医药卫生—内科学]