结核性胸膜炎患者外周血和胸水中Th17、Th1细胞检测分析

目的 探讨结核性胸膜炎患者Th17、Th1细胞免疫应答的特性及作用。方法 应用流式细胞术检测30例健康对照组（HD）、23例潜伏感染组（LTBI）、20例结核性胸膜炎组(TP) 患者外周血单个核细胞（PBMC）与胸水单个核细胞（PFMC）Th17、Th1细胞的变化情况。结果 结核性胸膜炎患组外周血非特异性Th17和Th1细胞百分比分别为（2.81±0.94）和（27.85±11.02）,低于健康对照组（4.63±1.63）、（36.34±9.39）和潜伏感染组（4.13±1.91）、（42.37±13.87）,差异有统计学意义（P<0.001,P<0.05）;结核性胸膜炎患者胸腔积液PFMC的非特异性Th17细胞百分比为（1.85±1.34）,低于外周血PBMC的（2.81±0.94）,差异有统计学意义(P<0.01);同时PFMC结核菌特异性Th17、Th1细胞的百分比分别为（0.68±0.13）和（6.91±1.16）,高于PBMC（0.25±0.11）和（1.98±0.56 ）,差异有统计学意义(P<0.01,P<0.001)。结论 结核性胸膜炎患者外周血非特异性Th17、Th1细胞应答及感染局部Th17的非特异性应答反应均受到抑制;感染局部特异性Th17、Th1应答处于高水平状态;Th17、Th1细胞应答在结核性胸膜炎的发病中发挥重要作用。

Th17, Th1 cells detection in peripheral blood and pleural fluid with tuberculous pleurisy

Objective To investigate the characteristics and role of Th17, Th1 cellullar immunologic response in patients with tuberculous pleurisy. Methods Intracellular staining and flow cytometry analysis were used to evaluate Th17, Th1 response in peripheral blood mononuclear cells（PBMC） and pleural fluid mononuclear cells（PFMC） samples collected from 30 healthy donors (HD), 23 individuals with LTBI, 20 patients with tuberculous pleurisy（TP）. Results We found that non-specific response of Th17, Th1 cells percentage in peripheral blood was significantly lower in patients with TP （2.81±0.94 and 27.85±11.02） than that of HD(4.63±1.63, 36.34±9.39) and individuals with LTBI(4.13±1.91, 42.37±13.87)（P<0.001, P<0.05）. Non-specific response of Th17 cells percentage was significantly lower in PFMC （1.85±1.34） compared to PBMC （2.81±0.94）（P<0.01）; the Th17, Th1 percentage of tuberculosis antigen-specific in PFMC（0.68±0.13 and 6.91±1.16） were significantly higher than that of PBMC(0.25±0.11 and 1.98±0.56) （P<0.01, P<0.001）. Conclusions Non-specific response of Th17, Th1 cells from peripheral blood and Th17 cells from pleural fluid in patients with TP were significantly inhibited. The antigen-specific Th17, Th1 response was at a high level in local infection. The Th17, Th1 cells response plays an important role in the pathogenesis of tuberculous pleurisy.