抗结核治疗对肺结核病患者血清TNF-α、IFN-γ、IL-10和IL-17表达差异的影响

Different serum levels of TNF-α,IFN-γ,IL-10 and IL-17 in pulmonary tuberculosis before and after anti-tuberculosis treatment

目的探讨肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)、白介素-10(IL-10)和白介素-17(IL-17)在肺结核病患者抗结核治疗前后表达的差异。方法选择新发未治疗的肺结核病患者20例,经抗结核治疗后肺结核病好转的患者20例,采集患者血清,采用ELISA方法检测TNF-α、IFN-γ、IL-10和IL-17的表达水平的差异,明确上述细胞因子在肺结核病患者抗结核治疗过程中的作用机制。结果肺结核病初诊患者血清中TNF-α、IL-17的含量较肺结核病患者治疗后好转的明显增高,分别为(144.05±59.15)pg/mL vs(97.55±20.58)pg/mL和(33.10±19.07)pg/mL vs(10.80±1.50)pg/mL,两组间比较差异具有统计学意义(P<0.05);而IFN-γ在肺结核病患者治疗好转组血清中较肺结核病初诊患者明显升高[(97.40±48.00)pg/mL vs(30.98±16.72)pg/mL],两组间比较差异具有统计学意义(P=0.000);但肺结核病初诊患者和治疗后好转组血清IL-10差异无统计学意义[(141.02±33.42)pg/mL vs(146.78±33.75)pg/mL]。结论肺结核病患者体内存在着明显的免疫紊乱,抗结核治疗后TNF-α、IL-17明显降低,而IFN-γ则明显升高,提示在抗结核治疗肺结核病患者的过程中,连续监测免疫学指标有助于判断抗结核治疗的疗效。

Objective To explore the different serum levels of TNF-a, IFN-γ, IL-10 and IL-17 in pulmonary tuberculosis before and after anti-tuberculosis treatment. Methods 20 newly diagnosed untreated cases of pulmonary tuberculosis and 20 cases undergone active anti-tuberculosis treatment were enrolled in the study. The concentrations of TNF-a, IFN-γ, IL-10 and IL-17 in sera, which might involve in the anti-tuberculosis mechanism, were determined using enzyme-linked immunosorbent assay （ELISA）. Results The serum levels of TNF-a and IL-17 in untreated patients were significantly higher than those in treated ones [ （ 144.05 ± 59. 15） pg/mL vs （97.55 ± 20.58） pg/mL for TNF-a and （33.10 ± 19.07 ） pg/mL vs （ 10.80 ± 1.50） pg/mL for IL-17, respectively ] （ P 〈 0. 05 ）, while the level of IFN-was obviously higher in successfully treated patients than in newly diagnosed cases [ （97.40±48.00） pg/mL vs （30.98 ± 16. 72） pg/mL] （P = 0. 000）. As to IL-10, however, there was no significant difference between the two groups [ （ 141.02 ± 33.42） pg/mL vs （ 146.78 ± 33.75 ） pg/mL]（P = 0. 591 ）. Conclusion There are immune disorders in patients with pul- monary tuberculosis. After successful anti-tuberculosis treatment, the serum levels of TNF and IL-17 were significantly reduced and the level of IFN-γ was significantly increased, which indicates that continuous monitoring of immunological indicators is helpful to determine the efficacy of anti-tuberculosis treatment.