结核性胸膜炎患者外周血及胸腔积液中CD4^+和CD8^+ T细胞的活化分析

CD4^+and CD8^+ T cell profiles of peripheral blood and pleural effusion collected from patients with tuberculous pleurisy

结核性胸膜炎的发病机制目前仍不清楚。研究表明,免疫缺陷是结核性胸膜炎的重要发病因素。本研究主要通过检测结核性胸膜炎患者外周血和胸腔积液中CD4+和CD8+T细胞的比例变化及其活化程度,分析并探讨结核性胸膜炎患者机体免疫状况。在筛选病例后收集患者的外周血和胸腔积液,分离出单核细胞,采用流式细胞仪检测CD4+和CD8+T细胞的比例以及人白细胞抗原DR(HLA-DR)表面活化标记和颗粒酶B在CD8+T细胞中的表达水平。结果显示,结核性胸膜炎患者外周血中CD3+、CD4+和CD8+T细胞的比例均低于健康对照组。患者胸腔积液中CD3+和CD4+T细胞的比例均显著高于外周血,而CD8+T细胞无显著差异。患者外周血中CD4+HLA+和CD8+HLA+T细胞显著高于健康对照组,而CD8+颗粒酶B+T细胞显著低于健康对照组。患者胸腔积液中CD4+HLA+、CD8+HLA+和CD8+颗粒酶B+T细胞均显著低于外周血,仅外周血中CD8+T细胞比例与颗粒酶B水平呈正相关。以上结果表明,结核性胸膜炎患者外周血与胸腔积液中的免疫应答存在差异,提示患者可能存在免疫缺陷。

The pathogenesis of tuberculous pleurisy remains unclear. Evidences have shown that immuno-im- balance is an important risk factor for this condition. The present paper aimed to profile CD4＋ and CD8＋ T cells in patients with tuberculous pleurisy. A total of 30 cases were selected and their peripheral blood and pleural fluid were collected. The mononuclear cells were isolated. The CD4＋ cells, CD8＋ T cells, activation surface markers of human leukocyte antigen （HLA）-DR, and granzyme B level in CD8＋ T cells were detec- ted by flow cytometry. The results showed that the proportions of CD3＋ , CD4＋ and CD8＋ T cells in pe- ripheral blood samples collected from the patients with tuberculous pleurisy were lower than those in the control group. The proportions of CD3＋ and CD4＋ T cells in patients＇ pleural effusion were higher thanthose in peripheral blood, but the proportion of CD8＋ T cells had no significant difference. The levels of HLA-DR on CD4＋ and CD8＋ T cells in peripheral blood in patients with tuberculous pleurisy were higher than those in the control group. And the level of CD8＋ granzyme B＋ T cells in patients with tuberculous pleurisy was lower than that in the control group. In patients, the levels of CD4＋ HLA＋ , CDS＋ HLA＋ and CD8＋ granzyme B＋ T cells in pleural effusion were lower than those in peripheral blood, In patients＇ pe- ripheral blood there was a positive correlation between CD8＋ T cells and granzyme B level. The results sug- gested that the immune response between peripheral blood and pleural fluid in patients with tuberculous pleu- risy were different. Immuno-imbalance may play a critical role in the development/prognosis of the disease.