IL-35、IL-17在人类免疫缺陷病毒混合结核感染中的免疫作用

Immune function of IL-35,IL-17 in mixed disease of human immunodeficiency virus infection and tuberculosis

目的:分析IL-35、IL-17在人类免疫缺陷病毒混合结核感染中的免疫作用。方法:研究对象分为两组:抗逆转录病毒治疗(ART)组共80例;ART治疗前HIV-TB双重感染组共50例,通过ART治疗方案及抗结核治疗方案,采集和处理血液样本并进行检测分析。结果:HIV-TB合并感染者,与HIV感染组相比,经治疗后Th17细胞数量增加,Treg细胞数量下降,IL-35数量下降,IL-17数量上升。HIV-TB组内发生TB-IRIS的与不发生的相比,Th17降低,IL-35升高,IL-17降低。随着时间变化,IL-17显著下降(P<0.05),IL-35显著上升(P<0.05),Treg显著下降(P<0.01)。IL-17/Treg/IL-35免疫应答与TB-IRIS转归相关性的高低排序为IL-17、Treg、IL-35。除IL-17免疫应答与TB-IRIS转归呈正相关外,其余均呈负相关。在0.05的水平上,TB-IRIS转归与IL-17/Treg/IL-35免疫应答的相关系数显著。结论:推测在HIV-TB双重感染中,IL-35可能通过下调Treg细胞水平和上调IL-17表达水平促进HIV-TB双重感染患者特异性细胞免疫反应,打破机体细胞免疫调节平衡,导致TB-IRIS的发生。

Objective： To analyze the immune function of IL-35,IL-17 in mixed disease of human immunodeficiency virus（ HIV） and tuberculosis infection. Methods： The research objects were divided into two groups： antiretroviral treatment（ ART） group having 80 cases totally; before ART HIV-TB dual infection group had a total of 50 cases.Through ART and anti-tuberculosis treatment,blood samples were collected,tested and analysised. Results：Compared with the HIV infection group,Th17 cells increased,Treg cells declined,IL-35 declined,IL-17 number increased after treatment in HIV-TB dual infection. In HIV-TB group,compared with without TB-IRIS,Th17 decreased,IL-35 increased,IL-17 decreased in TB-IRIS. As time changes,IL-17 declined significantly（ P 〈0. 05）,IL-35 significantly increased（ P 〈0. 05）,Treg cells dropped significantly（ P 〈0. 01）. IL-17 / Treg / IL-35 immune response and TB-IRIS outcomes association sequences were IL-17,Treg,IL-35. In addition to the IL-17 immune response were positively related with TB-IRIS,the rests were all negative correlation related. At the 0. 05 level,TB- IRIS outcome and IL- 17 / Treg / IL- 35 had immune response correlation coefficient significantly.Conclusion： In HIV-TB dual infection,IL-35 may decrease Treg cells level and increase IL-17 expression level,specific cellular immune response is promoted in HIV-TB dual infection patients,cellular immunity balance is broken,the TB-IRIS is caused.