结核性盆腔炎患者外周血T_H17/Treg细胞的表达

Analysis on T_H17/Treg cells in patients with pelvic tuberculousis

目的了解结核性盆腔炎患者外周血T_H17/Treg细胞免疫应答情况,探讨其在结核性盆腔炎发病中的作用。方法采用胞内流式细胞术分别检测46例结核性盆腔炎患者治疗前外周血T_H17和Treg细胞的表达水平,以健康育龄期妇女25例作为对照,并对28例患者抗结核治疗3个月和6个月后T_H17/Treg细胞的变化情况进行随访检测。结果结核性盆腔炎患者外周血T_H17细胞的百分比为(3.26±1.30)%,明显低于对照组(4.92±1.71)%(P<0.01),Treg细胞的百分比为(5.18±1.53)%,明显高于对照组(3.26±1.10)%(P<0.01);结核性盆腔炎患者治疗6个月后T_H17细胞表达水平(4.67±1.75)%明显高于治疗前(3.26±1.30)%及治疗3个月(3.70±1.06)%,差异均有统计学意义(P均<0.01);治疗6个月后Treg细胞表达水平为(3.93±0.94)%,明显低于治疗前(5.18±1.53)%及治疗3个月(4.94±1.51)%,差异有统计学意义(P均<0.01);治疗6个月后Treg细胞仍高于对照组(P<0.05);治疗前T_H17/Treg细胞的比值较对照组明显降低(P<0.01),治疗3个月后升高不明显,治疗6个月后T_H17/Treg细胞的比值(1.18±0.34)%较治疗3个月(0.77±0.21)%和治疗前(0.55±0.13)%升高明显(P均<0.01),但仍未恢复至正常水平(P<0.01)。结论 T_H17/Treg细胞参与了结核性盆腔炎患者的免疫应答,并存在T_H17/Treg的失衡状态。

Objective To investigate the cellular immunologic response of Tn 17/Treg ceils in the peripheral blood of pelvic tuberculo- sis patients and explore their roles in the pathogenesis of pelvic tuberculosis. Methods The intracellular flow cytometry was performed to evaluate the expressions of Tn 17 and Treg cells in 46 pelvic tuberculosis patients and 25 healthy controls in childbearing age. Twen- ty-eight of the 46 pelvic tuberculosis patients were followed up to monitor the variation of the TH17/Treg cells after 3 months and 6 months of anti-tuberculosis treatment. Results The percentage of TH 17 cells in the peripheral blood of pelvic tuberculosis patients was （ 3.26 ± 1.30） % which was significantly lower than that of healthy controls [ （4.92 ± 1.71 ） %, P 〈 0.01 ]. The percentage of Treg cells in the patients was （5.18 ± 1.53 ） % which was significantly higher than that of healthy controls [ （ 3.26 ＋ 1.10） %, P 〈 0.01 ]. The percentage of TH17 cells in the pelvic tuberculosis patients after 6 months of treatment was （4.67 ± 1.75） % which was significant- ly higher than that in the patients before treatment and after 3 months treatment [ （3.26 ± 1.30） %, P 〈 0.01 and （3.70 ± 1.06 ） %, P 〈 0.01, respectively]. The percentage of Treg cells in pelvic tuberculosis patient after 6 months of treatment was （3.93 ± 0.94）% which was significantly lower than that in the patients before treatment and after 3 months of treatment [ （5.18 ± 1.53）%, P 〈0.01 and （4.94 ±1.51 ） %, P 〈0.01, respectively]. The percentage of Treg cells in the patients after 6 months of treatment was still sig- nificantly higher than that of controls （P 〈 0.05 ）. The T 17/Treg ratio before treatment was significantly lower than that of healthy controls （ P 〈0.01 ）, and the Tal7/Treg ratio was increased after 3 months of treatment but it did not show significant difference com- pared with that before treatment. The TH 17/Treg ratio after 6 months of treatment （ 1.18 ± 0.34） % was significantly increased in contrast to those after 3 months of treatment and before treatment [ （0.77 ± 0.21 ） %, P 〈 0.01 and （0.55 ± 0.13 ） %, P 〈 0.01, respectively ]. The TH17/Treg ratio could not rise to the normal level even after 6 months of treatment. Conclusion Both the TR17 and Treg cells may involve in the immunologic responses of pelvic tuberculosis patients and the imbalance of Tn 17/Treg cells may remain persistently.