肺结核患者外周血Th17/Treg的表达及其病理意义

Peripheral blood Th17/Treg ratio in patients with pulmonary tuberculosis and its pathological significance

为探讨肺结核患者外周血Th17与Treg的表达及其病理意义,收集2017年1月至2018年6月青海省第四人民医院收治的80例肺结核患者作为结核组,同期收集80例健康成人作为对照组。观察两组外周血Th17与Treg及其细胞因子的表达情况,同时分析Th17与Treg及其细胞因子与肺结核患者病情严重程度的相关性。结果显示,与对照组比较,结核组Th17降低[(2.69±0.93)%vs(1.94±0.91)%,P=0.000],Treg升高[(7.88±2.65)%vs(9.60±2.59)%,P=0.000],IL-17降低[(32.89±8.92) pg/mL vs(25.72±9.62) pg/mL,P=0.000],IL-10升高[(22.80±6.81) pg/mL vs(26.61±7.62) pg/mL,P=0.001]。肺结核患者病灶数目、直径总和与Th17、IL-17呈显著负相关(P<0.05),与Treg、IL-10呈显著正相关(P<0.05)。与无空洞形成的患者比较,空洞形成的患者Th17降低[(2.06±0.62)%vs(1.76±0.68)%,P=0.045],Treg升高[(8.79±2.12)%vs(10.81±2.41)%,P=0.000],IL-17和IL-10差异无统计学意义(P>0.05)。提示外周血中Th17与Treg在肺结核患者中表达异常,与结核病情严重度相关。

To investigate the peripheral blood Th17/Treg imbalance in pulmonary tuberculosis patients and its pathological significance, a prospective study was conducted in the Fourth People’s Hospital of Qinghai Province which included 80 patients with pulmonary tuberculosis and 80 healthy adults. The ratio of Th17/Treg and Th1 and Th17 related cytokines in peripheral blood of the two groups were measured, and the correlations between Th17/Treg ratio and levels of the cytokines and the severity of pulmonary tuberculosis were analyzed. The results showed that, compared with the control group, the Th17 number decreased in the patient group[(2.69±0.93)% vs(1.94±0.91)%, P=0.000] and the Treg number increased[(7.88±2.65)% vs(9.60±2.59)%, P=0.000], as to the cytokines, IL-17 decreased [(32.89±8.92)pg/mL vs(25.72±9.62)pg/mL, P=0.000] and IL-10 increased [(22.80±6.81)pg/mL vs(26.61±7.62)pg/mL, P=0.001]. The number and diameter of tuberculosis lesions were negatively correlated with Th17 and IL-17(P<0.05), and positively correlated with Treg and IL-10(P<0.05). Compared with patients without void formation, Th17 decreased in those with void formation [(2.06±0.62)% vs(1.76±0.68)%, P=0.045], whereas Treg increased [(8.79±2.12) % vs(10.81±2.41)%, P=0.000]. However, there was no significant difference between the two subgroups of patients in IL-17 and IL-10 concentration(P>0.05). Together, Th17/Treg ratio in peripheral blood is abnormal in patients with pulmonary tuberculosis, which appears related to the severity of tuberculosis.