治疗期肺结核患者外周血中免疫调节细胞特异性基因mRNA丰度动态观察  

Dynamic observation of mRNA abundance of immunoregulatory cell-specific gene in peripheral blood of patients with pulmonary tuberculosis during the treatment period

作　　者：王怡心[1] 陈雄豪 莫俊銮[3] 蒋英[1] 林惠玲[1] 于飞 WANG Yixin;CHEN Xionghao;MO Junluan;JIANG Ying;LIN Huiling;YU Fei(Department of Laboratory Medicine,Futian District Hospital for Prevention and Treatment of Chronic Diseases,Shenzhen,Guangdong 518040,China;Department of Laboratory Medicine,Futian District Maternal and Child Health Hospital,Shenzhen,Guangdong 518040,China;Chronic Disease Laboratory,Shenzhen Center for Chronic Disease Control and Prevention,Shenzhen,Guangdong 518020,China)

机构地区：[1]深圳市福田区慢性病防治院检验科,广东深圳518040 [2]深圳市福田区妇幼保健院检验科,广东深圳518040 [3]深圳市慢性病防治中心慢病实验室,广东深圳518020

出　　处：《中国热带医学》2020年第10期962-966,共5页China Tropical Medicine

基　　金：深圳市福田区卫生公益性科研项目(No.FTWS2019078)。

摘　　要：目的动态监测治疗期肺结核(tuberculosis,TB)患者外周血中T-bet、GATA-3、RORγt和Foxp3等免疫调节细胞特异性基因mRNA丰度变化,探索结核病变过程中机体的免疫调节趋势及作用。方法选择52例确诊肺结核患者为病例组,50名体检健康者作为对照组。通过实时定量PCR方法测定上述基因以及IFN-γ、IL-4、IL-17、IL-10等细胞因子特异性基因在治疗期第0个月、3个月、6个月的表达水平,动态观察患者及健康人群体内免疫调节平衡Th1/Th2和Th17/Treg变化。结果初诊组T-bet mRNA表达、RORγt/Foxp3分别低于正常对照组(P<0.05),RORγt和Foxp3 mRNA表达分别高于正常对照组(P<0.05);初诊组和治疗3月组GATA-3 mRNA的表达均高于正常对照组(P<0.05),T-bet/GATA-3均低于正常对照组(P<0.05)。治疗6月组T-bet mRNA、T-bet/GATA-3分别高于初诊组和治疗3月组(P<0.05);治疗3月组和治疗6月组RORγt、Foxp3 mRNA均分别低于初诊组(P<0.05)。初诊组和治疗组IFN-γmRNA均低于对照组,IL-4、IL-17、IL-10的mRNA均高于对照组(P<0.05)。结论肺结核患者存在转录因子水平Th1/Th2失衡,呈现Th2漂移现象。Th17细胞和Treg细胞可能在TB的发生过程中起着重要的促炎作用和免疫抑制作用。抗结核治疗能够改善上述转录因子的异常表达。Objective Dynamic monitoring of T-bet,GATA-3,RORγt and Foxp3 immunomodulatory cell-specific gene mRNA abundance in peripheral blood of patients with tuberculosis(TB)were conducted during treatment to explore the immunomodulatory trends and effects of tuberculosis lesions.Methods Totally 52 confirmed TB patients were selected as treatment group and 50 healthy patients as control group.Real-time quantitative PCR was used to determine the expression of the above gene as well as the IFN-γ,IL-4,IL-17,IL-10 transcription factors at the 0 month,3 months and 6 months of the treatment period.The ratio changes of immunomodulatory balance Th1/Th2 and Th17/Treg in patients and healthy populations were dynamically observed.Results In the first visit group,T-bet mRNA expression and RORγt/Foxp3 ratio were lower than the control group(P<0.05),the expression of RORγt and Foxp3 mRNA were higher than those in the control group(P<0.05);In the first visit group and the 3 months treatment group,the GATA-3 mRNA expression were higher than that in the control group(P<0.05),and the T-bet/GATA-3 ratios were lower than that in the control group(P<0.05).The T-bet mRNA expression and the T-bet/GATA-3 ratio of the 6 months treatment group were significantly higher than the first visit group and the 3 months treatment group(P<0.05);In the 3 months and 6 months treatment groups,the mRNA expression of RORγt and Foxp3 were lower than those in the first visit group(P<0.05).In the first visit group and treatment group,the mRNA expression of IFN-γwas lower than that in the control group(P<0.05),the mRNA expression of IL-4,IL-17 and IL-10 were higher than those in the control group(P<0.05).Conclusion TB patients have Th1/Th2 imbalance of transcription factor level,showing Th2 drift phenomenon.Th17 cells and Treg cells may play an important pro-inflammatory and immunosuppressive roles in the development of TB.Anti-tuberculosis treatment can improve their abnormal expression.

关 键 词：肺结核 辅助性T细胞 T-BET基因 GATA-3基因 RORγt基因 FOXP3基因 MRNA表达水平 

分 类 号：R521[医药卫生—内科学]