抗结核治疗对肺结核患者Th17/Treg的影响

目的分析抗结核治疗前后肺结核患者外周血(CD3+CD4+IL-17+)辅助性T细胞17(Th17)和(CD4+CD25+Foxp3+)调节性T细胞(Treg)平衡状态的变化及其临床意义。方法收集本院2014年10月至2015年5月感染科收治的肺结核患者80例,选择30例健康体检者作为对照组。流式细胞术检测患者抗结核药物治疗前、治疗6个月以及对照组的外周血Th17细胞和Treg细胞的表达,ELISA检测外周血中IL-17A的表达。结果流式结果显示,治疗前肺结核患者外周血Th17细胞,Treg细胞表达率为分别为(1.18±0.74)%、(7.68±0.92)%,均明显低于健康体检者((3.95±1.17)%,(4.17±1.12)%,P0.05);治疗6个月后肺结核患者外周血Th17细胞,Treg细胞表达率分别为(2.98±1.42)%,(5.26±0.72)%,均明显高于治疗前、但仍显著低于健康体检者(P0.05)。治疗前肺结核患者Th17/Treg为0.15±0.21,明显低于健康体检者(0.95±0.45,P0.05);治疗6个月后肺结核患者Th17/Treg为0.56±0.39,明显高于治疗前、但仍显著低于健康体检者(P0.05)。ELISA检测结果显示,治疗6个月后肺结核患者外周血IL-17A表达水平为39.06±5.83 pg/m L,明显高于治疗前、但仍显著低于健康体检者(P0.05)。结论结核分枝杆菌可破坏肺结核患者机体Th17/Treg平衡,抗结核治疗可缓解患者外周血Th17/Treg失衡状态。

Effect of anti-tuberculosis therapy on the balance state of Th17 cells and regulatory T cells in patients with tuberculosis

Objective To determine the balance state of ( CD3 +CD4 +IL-17 +) Th17 cells and ( CD4 +CD25+Foxp3+) regulatory T cells in patients with tuberculosis and to explore the clinical significance. Methods 80 patients with tuberculosis from Oct 2014 to May 2015 were enrolled, and 30 healthy persons were selected as the control group. Flow cytometry was used to measure the percentage of Th17 cells and Treg on CD4 + T cells in pa-tients’ peripheral blood at the time of 0, 6 month and in peripheral blood of the control group. The level of IL-17A was detected by ELISA. Results Analysis of flow cytometry showed the proportion of Th17 cells in patients was (1. 18 ± 0. 74)%, which was significantly lower than in the control group ((3. 95 ± 1. 17)%, P<0. 05). After 6 months’ anti-tuberculosis treatment, the proportion of Th17 cells in patients was obviously higher (2. 98 ± 1. 42%) than pre-treatment (P<0. 05), but still lower than that in the control group (P<0. 05). Whereas Treg showed in an opposite way to the Th17 cells. The ratio of Th17/Treg in patients and the level of IL-17A after 6 months’ treat-ment was evidently higher (0. 56 ± 0. 39, 39. 06 ± 5. 83 pg/mL) than pre-treatment (0. 15 ± 0. 21, 20. 32 ± 5. 71 pg/mL), but still lower than that in the control group (0. 95 ± 0. 45, 52. 77 ± 4. 79 pg/mL, P<0. 05). Conclusion Tuberculosis breaks the balance between Th17 cells and Treg cells, which could be recovered by anti-tuberculosis therapy.