Treg细胞对慢性期布鲁菌病患者治疗的影响

Effects of Treg cells on treatment of chronic brucellosis patients

目的观察慢性期布鲁菌病(简称布病)患者外周血中调节性T细胞(Treg)占淋巴细胞的百分比及不同方案治疗前后Treg细胞的变化,分析Treg细胞诱导的免疫抑制对慢性期布病治疗效果的影响。方法采用病例-对照研究方法,以黑龙江省农垦总局总医院感染三科住院的35例慢性期布病患者[男性28例、女性7例,年龄(45.37±20.16)岁]为病例组,根据采取的治疗方案将其分为标准治疗组(15例)和免疫增强剂组(20例),疗程为20d;另选择30例医院健康体检者[男性16例、女性14例,年龄(35.53±11.38)岁]为对照组。分别在治疗前后采集研究对象外周血,流式细胞术检测外周血中Treg细胞占淋巴细胞的百分比,并分析不同治疗方案布病患者外周血中Treg细胞占淋巴细胞百分比的变化情况。结果治疗前,对照组、标准治疗组和免疫增强剂组人群外周血中Treg细胞占淋巴细胞的百分比[(1.69±0.38)%、(3.12±0.86)%、(3.05±1.07)%]组间比较差异有统计学意义(F=25.89,P<0.05);与对照组比较,标准治疗组和免疫增强剂组外周血中Treg细胞占淋巴细胞的百分比升高(P均<0.05);标准治疗组和免疫增强剂组间比较差异无统计学意义(P>0.05)。治疗后,对照组、标准治疗组和免疫增强剂组外周血中Treg细胞占淋巴细胞的百分比[(1.69±0.38)%、(3.06±0.76)%、(2.85±0.89)%]组间比较有差异有统计学意义(F=30.84,P<0.05);与对照组比较,标准治疗组和免疫增强剂组外周血中Treg细胞占淋巴细胞的百分比升高(P均<0.05);标准治疗组和免疫增强剂组间比较差异无统计学意义(P>0.05),且分别与同组治疗前比较,差异无统计学意义(P均>0.05)。结论慢性期布病患者外周血中Treg细胞占淋巴细胞的百分比在不同治疗方案间及治疗前后均无明显变化,提示Treg细胞诱发的免疫抑制可能使宿主机体无法有效清除体内残余布鲁菌,进而造成慢性感染。

Objective To investigate the percentage of regulatory T cells(Treg)in peripheral blood lymphocytes of patients with chronic brucellosis and the percentage change before and after treatment of different regimens,and to analyze the influence of Treg cell-induced immunosuppression on the therapeutic effect of chronic stage brucellosis.Methods Using case-control study,35 patients with chronic brucellosis who were hospitalized in Heilongjiang General Hospital of Agriculture Bureau [28 males,7 females,aged(45.37 ± 20.16)years old] were selected as case group.According to the treatment regimen,they were divided into standard treatment group(15 cases)and immune enhancer group(20 cases),the treatment was 20 d;30 cases of in-hospital health examinations were selected [16 males and 14 females,aged(35.53 ± 11.38)years old] as control group.Peripheral blood sample of the subject was collected before and after the treatment,the Treg cells as a percentage in peripheral blood lymphocytes were detected by flow cytometry.And the percentage change of Treg cells of brucellosis patients who underwent different treatment regimens was analyzed.Results Before treatment,the percentage of Treg cells in peripheral blood lymphocytes of the control group,the standard therapy and the immune enhancer groups [(1.69 ± 0.38)%,(3.12 ±0.86)%,(3.05 ± 1.07)%] was significantly different(F= 25.89,P<0.05);compared with the control group,the percentage of Treg cells in the peripheral blood lymphocytes of the standard treatment group and the immune enhancer group increased(P<0.05);there was no significant difference between the standard treatment group and the immune enhancer group(P>0.05).After treatment,the percentage of Treg cells in peripheral blood lymphocytes of the control group,the standard therapy and the immune enhancer groups [(1.69 ± 0.38)%,(3.06 ± 0.76)%,(2.85 ± 0.89)%] was significantly different(F= 30.84,P<0.05);compared with the control group,the percentage of Treg cells in the peripheral blood lymphocytes of the standard treatment group and the immune enhancer group increased(P<0.05);there was no significant difference between the standard treatment group and the immune enhancer group(P>0.05),and compared with the same group before the treatment,respectively,the differences were not statistically significant(P>0.05).Conclusions The percentages of Treg cells in peripheral blood lymphocytes of the chronic brucellosis patient are not significantly changed before and after different treatment regimens.It suggests that the immunesuppression induced by Treg cells may be one of the reasons why the host organism cannot effectively remove residual Brucella in the body,which leads to chronic infection.