MAIT细胞及其分泌因子表达与肺结核病情严重程度的关系

The relationship between MAIT cells,their excreted factors and the severity of tuberculosis

目的探究血粘膜相关恒定T细胞(MAIT)及其分泌因子干扰素-γ(IFN-γ)、肿瘤坏死因子-α(TNF-α)、颗粒酶B(Granzyme B)、白细胞介素17(IL-17)表达与肺结核患者病情严重程度的关系。方法选取2017年1月至2019年3月入院治疗的肺结核患者142例,根据患者肺结核的不同类型分组:初治组(n=68)和复治组(n=74),根据肺部病灶范围分组:A组(1~2个肺野)(n=62)、B组(3~4个肺野)(n=45)和C组(5~6个肺野)(n=35),根据肺部是否有空洞分组:空洞组(n=59)和无空洞组(n=83)。并选取45例健康志愿者作为对照组,采用流式细胞仪检测各组外周血MAIT细胞及其分泌因子IFN-γ、TNF-α、Granzyme B及IL-17水平。结果肺结核组患者外周血MAIT细胞比例、分泌IFN-γ、TNF-α及Granzyme B的MAIT细胞比例显著低于对照组,分泌IL-17的MAIT细胞比例显著高于对照组,差异均有统计学意义(P<0.05)。A组、B组及C组患者外周血MAIT细胞及其分泌细胞因子水平比较差异有统计学意义(P<0.05),其中A组MAIT细胞及分泌IFN-γ、TNF-α及Granzyme B水平高于B组和C组,分泌IL-17水平低于B组和C组,差异均有统计学意义(P<0.05),初治组与复治组、空洞组与无空洞组外周血MAIT细胞比例及其分泌细胞因子水平比较差异无统计学意义(P>0.05)。结论肺结核患者外周血MAIT细胞功能存在明显缺陷,病灶范围较广的患者MAIT细胞功能缺陷更明显,临床检测MAIT细胞功能可为肺结核患者病情评估提供参考。

Objective To explore the relationship between expression of mucosal-associated invariant T(MAIT) cells,their excreted factors [interferon-γ(IFN-γ),tumor necrosis factor-α(TNF-α),granzyme B(Granzyme B),interleukin 17(IL-17)] and the severity of tuberculosis patients.Methods A total of 142 tuberculosis patients who were admitted to the hospital from January 2017 to March 2019 were enrolled.According to different types of tuberculosis,they were divided into the initial treatment group(n=68) and the re-treatment group(n=74).According to the ranges of lung lesions,they were divided into group A(1-2 lung fields)(n=62),group B(3-4 lung fields)(n=45) and group C(5-6 lung fields)(n=35).According to presence or absence of lung cavities,they were divided into the cavity group(n=59) and the non-cavity group(n=83).Another 45 healthy volunteers were enrolled as the control group.The number of MAIT cells and their secreted factors(IFN-γ,TNF-α,Granzyme B,IL-17) in peripheral blood in each group were detected by flow cytometry.Results The proportions of MAIT cells in peripheral blood,and proportion of MAIT cells secreting IFN-γ,TNF-α and Granzyme B in the tuberculosis group were significantly lower than those in the control group,while the proportion of MAIT cells secreting IL-17 was significantly higher than that in the control group(P<0.05).The differences in levels of MAIT cells and their excreted cytokines in groups A,B and C were statistically significant(P<0.05).The levels of MAIT cells,IFN-γ,TNF-α and Granzyme B in group A were higher than those in groups B and C,while level of IL-17 was lower than that in groups B and C(P<0.05).The differences in the proportion of MAIT cells and levels of their excreted cytokines between the initial treatment group and the re-treatment group,the cavity group and the non-cavity group were not statistically significant(P>0.05).Conclusion There are obvious defects in the function of MAIT cells in the peripheral blood of pulmonary tuberculosis patients,and the functional defects of MAIT cells in patients with a wider range of lesions are more obvious.The clinical detection of MAIT cell function can provide a reference for the evaluation of the condition of pulmonary tuberculosis patients.