肺结核患者肺灌洗液细胞分泌γ干扰素和白细胞介素12的变化

Alteration of interferon gamma and interleukin 12 released by bronchoalveolar lavage cells from pulmonary tuberculosis

目的 探讨肺结核患者支气管肺泡灌洗液细胞分泌细胞因子水平的变化及其对临床表现的影响。方法 分别对 10名健康志愿者、10例肺结核患者健侧肺、10例轻症初治和 10例迁延不愈的肺结核患者病变肺局部进行了支气管肺泡灌洗 ,获取肺泡巨噬细胞 (AM)和淋巴细胞 ,用双抗体夹心酶联免疫吸附法分别测定了经脂多糖刺激AM培养上清液中白细胞介素 12 (IL 12 )和经植物血凝素刺激的淋巴细胞培养上清液中的γ干扰素 (IFN γ)和IL 4水平。结果 轻症组的IFN γ和IL 12水平分别为 (834± 10 1)和 (2 94± 73)ng/L ,不但明显高于健侧肺组 [(197± 5 9)和 (6 7± 2 3)ng/L ,P均 <0 0 1]及健康对照组 [(179± 5 1)和 (5 7± 2 4)ng/L ,P均 <0 0 1],也明显高于迁延组 [(4 31± 16 9)和 (12 1± 6 3)ng/L ,P均 <0 0 1];迁延组的IFN γ和IL 12水平明显高于健侧肺组和正常对照组 (P均 <0 0 1) ;四组间IL 4水平差异无显著性 (P均 >0 0 5 )。结论 肺结核病人病变肺局部存在TH1型细胞免疫反应 ,该反应也许与AM产生的IL 12密切相关 ,肺结核病灶局部产生的IFN γ和IL

Objective To explore the change of cytokine released in bronchoalveolar lavage fluid (BALF) cells from pulmonary tuberculosis (TB) patients.Methods BALF cells were obtained from group A: 10 normal control volunteers (normal control group); group B: 10 radiographically uninvolved sites of pulmonary TB patients (uninvolved sites group); group C: radiographically involved two lobes of lung and smear positive of 10 pulmonary TB patients with an onset less than one year; and group D: radiographically involved more than three lobes and smear positive of 10 pulmonary TB patients with an onset longer than two years. The IFN γ and IL 4 production in the culture supernate of BALF lymphocytes stimulated with PHA and IL 12 production in the culture supernate of BALF macrophage (AM) stimulated with lipopolysaccharide were determined using sandwich ELISA.Results In group C, the IFN γ and IL 12 levels [(834±101) and (294 ±73)ng/L, respectively] were not only significantly higher than those of the group B[(197±59) and (67±23)ng/L, respectively, all P <0.01] and normal control group[(179±51) and (57±24) ng/L, respectively, all P <0.01], but also significantly higher than those of group D [(431±169) and (121±63) ng/L, respectively, all P <0.01]; in group D, the IFN γ and IL 12 levels were significantly higher than those of the group B and normal control group (all P <0 01); there were no significant differences between the group C and normal control group ( P >0 05); no differences were seen in IL 4 level among the 4 study groups.Conclusions A TH1 type response occurs in involved sites of pulmonary TB patients and that may result from AM which as a regulator through production of IL 12, and the TH1 type response may affect presentation and outcome in pulmonary TB.