外周血单个核细胞中CD69、CD40L表达在识别抗结核药物诱导超敏反应致敏药物中的价值  

Value of CD69 and CD40L expression in peripheral blood mononuclear cells in identifying culprit drug of antituberculosis drugs

作　　者：吴于青[1] 姜国强 宗佩兰[1] WU Yuqing;JIANG Guoqiang;ZONG Peilan(Tuberculosis Department of Jiangxi Chest Hospital,Nanchang 330006,China)

机构地区：[1]江西省胸科医院结核科

出　　处：《实用医学杂志》2019年第12期1875-1879,共5页The Journal of Practical Medicine

基　　金：江西省自然科学基金项目(编号:20151BAB215003)

摘　　要：目的观察药物刺激后抗结核药物超敏反应患者外周血单个核细胞(peripheral blood mononuclear cells,PBMCs)中CD69、CD40L的表达变化,与药物激发试验结果比较,评价其在识别此类患者致敏药物中的价值。方法选择在我院初治肺结核治疗过程中出现超敏反应的患者26例为病例组,同期未出现超敏反应的对照组10例,采外周静脉血进行细胞原代分离后分别加入结核药进行细胞培养,通过流式细胞仪检测细胞中CD40L和CD69两种蛋白的表达。结果根据后期药物激发试验结果将入组患者分为致敏药物组和非致敏药物组;与对照组相比,致敏药物组患者PBMCs中表达CD40L、CD69的细胞比例明显升高,而非致敏药物组PBMCs中表达CD40L、CD69的细胞比例无明显差异性,同时致敏药物组与非致敏药物组相比差异有统计学意义。结论抗结核药物超敏反应患者外周血单个核细胞经致敏药物刺激后CD69、CD40L表达增加,这可能是一种用于识别此类患者致敏药物的有意义的体外检测方法。Objective To observe the expression of CD69 and CD40 L in peripheral blood mononuclear cells(PBMCs)of patients with antituberculosis drug hypersensitivity after suspicious drug stimulation,and to evaluate the value of CD69 and CD40 L in identifying allergenic drugs in such patients according to the results of drug provocation test. Methods Twenty-six patients with hypersensitivity were selected as the case group,while10 patients without as the control group. PBMCs were isolated from peripheral venous blood and cultured with suspected tuberculosis drugs. Expression of CD40 L and CD69 protein in cells was detected by flow cytometry.Results The patients were divided into culprit drug group and non-culprit drug group according to the results of drug provocation test. Compared with that in the control group,the percentage of CD40 L and CD69 cells in PBMCs of culprit drug group was significantly higher than that of non-culprit drug group,while in PBMCs of culprit drug group it was not significantly different from that of non-culprit drug group,and there was significant difference between culprit drug group and non-culprit drug group. Conclusion The expression of CD69 and CD40 L in PBMCs of patients with antituberculosis drug hypersensitivity increases after stimulation by culprit drugs,which may be a meaningful in vitro detection method for identifying culprit drugs in such patients.

关 键 词：结核病 超敏反应 致敏药物 流式细胞检测 

分 类 号：R52[医药卫生—内科学]