不同结核感染人群CD4+记忆T细胞亚群及炎症因子表达的差异  

Differences in Expression of CD4+Memory T Cell Subsets and Inflammatory Factors in People Infected with MTB at Different Stages

作　　者：全斌 王妮 张强 QUAN Bin;WANG Ni;ZHANG Qiang(Department of Infectious Diseases,the First Affiliated Hospital of Wannan Medical College,Wuhu City,Anhui Province 241001)

机构地区：[1]皖南医学院第一附属医院感染性疾病科,安徽省芜湖市241001

出　　处：《医学理论与实践》2025年第1期38-41,共4页The Journal of Medical Theory and Practice

基　　金：皖南医学院中青年科研项目(WK2021F20)。

摘　　要：目的:研究CD4^(+)记忆T细胞亚群、炎症因子在不同结核感染人群[结核潜伏感染组(LTBI组)、健康对照组(对照组)以及活动性肺结核组(PTB组)]的表达水平差异及临床意义。方法:采用流式细胞术检测外周血CD4^(+)T细胞亚群,ELISA法检测炎症因子[白细胞介素17(IL-17)、干扰素-γ(IFN-γ)]水平。结果:(1)CD4^(+)T淋巴细胞:对照组以CD4^(+)Tn为主,占比(44.65±8.23)%,其CD4^(+)Tcm的占比要低于PTB组和LTBI组,CD4^(+)Tem的占比低于PTB组(均P<0.05),CD4^(+)Tcm在三组间表达水平均有显著差异(均P<0.05),而LTBI组和对照组间的CD4^(+)Tem表达水平无统计学差异(P>0.05)。(2)血浆IFN-γ在三组间的表达水平均有显著差异(均P<0.05),LTBI组和对照组间的IL-17表达水平无统计学差异(P>0.05)。(3)PTB组在有效抗结核后CD4^(+)Tcm比例增高,CD4^(+)Tem降低,炎症因子(IL-17、IFN-γ)表达水平减少(均P<0.05)。结论:结核分枝杆菌(MTB)感染人体后不同阶段的外周血CD4^(+)记忆T细胞亚群的平衡状态不同;检测CD4^(+)Tcm、CD4^(+)Tem、IL-17和IFN-γ不仅可作为MTB感染人群初步筛查的实验指标,还有助于活动性PTB抗结核疗效的评估,CD4^(+)Tcm和IFN-γ有望作为PTB、LTBI患者鉴别诊断的标志物。Objective:To investigate the expression and significance of CD4^(+)memory T cell subsets and inflammatory factors in patients with different stages of tuberculosis infection[(latent tuberculosis infection(LTBI group),healthy control group(control group)and active tuberculosis patients group(PTB group)].Methods:The subpopulation of peripheral blood were determined by flow cytometry and the levels of inflammatory factors interleukin 17(IL-17),interferon-γ(IFN-γ)by ELISA.Results:(1)CD4^(+)T lymphocytes:The control group was dominated by CD4^(+)Tn(44.65±8.23)%,and the proportion of CD4^(+)Tcm was lower than that of PTB group and LTBI group,the proportion of CD4^(+)Tem was lower than PTB group(all P<0.05),CD4^(+)Tcm varied significantly between the three groups(all P<0.05),while the difference in CD4^(+)Tem between LTBI group and control group was not statistically significant(P>0.05).(2)The concentration of plasma IFN-γwas significantly different between the three groups(all P<0.05),and there was no statistical difference in IL-17 expression levels between LTBI group and control groups(P>0.05).(3)PTB group increased the proportion of CD4^(+)Tcm,decreased CD4^(+)Tem,and decreased the expression levels of inflammatory factors(IL-17,IFN-γ)(all P<0.05).Conclusion:The balance of CD4^(+)memory T subsets in different stages of MTB infection is different;the detection of CD4^(+)Tcm,CD4^(+)Tem,IL-17 and IFN-γcan be not only used for preliminary screening of MTB infected population,but also for the evaluation of anti-TB efficacy in PTB patients.CD4^(+)Tcm and IFN-γare expected to be useful as markers in the differential diagnosis of patients with PTB and LTBI.

关 键 词：肺结核 结核潜伏感染 记忆T细胞 白细胞介素17 干扰素-Γ 

分 类 号：R52[医药卫生—内科学]