CD_8^+CD_(28)^-T淋巴细胞在肺结核发病机制中的作用

The role of CD_8^+ CD_(28)^- regulatory T lymphocytes in pulmonary tuberculosis

目的探讨 CD_8^+CD_(28)^-T 淋巴细胞在肺结核发病机制中的作用。方法 30例病例为2005年3月至5月遵义医学院附属医院呼吸内科住院及门诊患者,采用流式细胞术检测15例肺结核组患者外周血中 CD_8^+CD_(28)^-T 淋巴细胞比值、细胞内白细胞介素6(IL-6)水平,以及 CD_3^+、CD_3^+CD_8^+、CD_8^+CD_(28)^-T 淋巴细胞比值,15例慢性支气管炎急性发作期患者作为疾病对照组,15名健康人作为健康对照组。结果肺结核组和疾病对照组 CD_3^+T 淋巴细胞分别为(41±16)%和(40±10)%,均显著低于健康对照组[(44±6)%];肺结核组和疾病对照组 CD_8^+CD_(28)^-T 淋巴细胞[(47±16)%和(44±10)%]均显著高于健康对照组[(41±12)%];肺结核组 CD_8^+CD_(28)^-T 淋巴细胞[(15±8)%]显著低于疾病对照组[(20±7)%],两组均显著低于健康对照组[(32±9)%];肺结核组 CD_8^+CD_(28)^-T 淋巴细胞[(27±9)%]显著高于疾病对照组[(22±9)%],两组均显著高于健康对照组[(10±4)%];肺结核组 CD_8^+CD_(28)^-T 淋巴细胞分泌的 IL-6水平[(32.4±2.4)%]显著高于疾病对照组和健康对照组[(19.7±3.2)%和(15.2±2.7)%]。结论肺结核患者 CD_8^+CD_(28)^-T 淋巴细胞及其分泌的 IL-6水平在外周血中上调, CD_8^+CD_(28)^-T 淋巴细胞水平在外周血中下调。 CD_8^+CD_(28)^+和 CD_8^+CD_(28)^-T 淋巴细胞及其分泌的 IL-6可能参与肺结核的发病机制。 CD_8^+CD_(28)^+和 CD_8^+CD_(28)^-T 淋巴细胞比值及其分泌的 IL-6水平可作为活动性肺结核的辅助诊断指标。

Objective To study the role of CD8^＋CD28^- regulatory T cells in tuberculosis. Methods The positive rates of CD3^＋ CD8^＋ CD28^- T cells, CD3^＋ T cells, CD3^＋ CD8^＋ T cells and CD8^＋ CD28^＋ T cells, and the content of IL-6 in CD8^＋ CD28^- T cells in leukocytes of peripheral blood from 15 patients with pulmonary tuberculosis, 15 patients with chronic bronchitis and 15 healthy controls were detected by flow cytometry. Results The positive expression rates of CD3T cells of tuberculosis group [ （41 ± 16）% ] and bronchitis controls [ （40 ± 10 ）% ] were significantly lower than those from healthy controls [ （44 ± 6 ）% ] respectively, but no differences were found between tuberculosis group and bronchitis controls. The CD3^＋CD8^＋ T cells in CD3^＋ T cells from the tuberculosis group [ （47 ± 16）% ] and bronchitis controls [ （44 ± 10）% ] were significantly higher than those from the healthy controls [ （41 ± 12）% ] respectively, but no differences were found between the tuberculosis group and bronchitis controls. The CD8^＋CD28^＋T cells in CD T cells from tuberculosis group [ （ 15 ± 8 ） % ] and bronchitis controls （ 20 ± 7% ） were significantly lower than those from healthy controls [ （32 ± 9 ）% ] respectively, and those of the tuberculosis group were significantly lower than those from the bronchitis controls. CD8^＋ CD28^- T cells in CD3^＋ T cells from tuberculosis group [ （27 ± 9）% ] and bronchitis controls [ （22 ± 9）% ] were significantly higher than those from healthy controls [ （ 10 ± 4） % ] respectively, and those of the tuberculosis group were significantly higher than those of the bronchitis controls. The level of IL-6 secreted by CD8^＋ CD28^- T cells from tuberculosis group [ （32. 4 ± 2. 4） % ] was significantly higher than bronchitis controls [ （ 19. 7 ± 3.2） % ] and healthy controls [ （ 15.2 ± 2. 7） % ] and no differences were found between bronchitis controls and healthy controls. Conclusions The number of CD8^＋ CD28^- T ceils and their production of IL-6 in the peripheral blood of tuberculosis patients are significantly increased as compared with the control groups, while the number of CD8^＋ CD28^＋ T cells （ cytotoxic T cell） is significantly decreased . The results suggest that these cells and IL-6 may be involved in the pathogenesis of pulmonary tuberculosis.