辅助性T细胞亚群失衡与结核病的关系

Th_1/Th_2 Imbalance in Patients with Tuberculosis

目的 通过检测结核病患者外周血和局部病灶的辅助性T细胞亚群细胞因子的表达 ,探讨结核病患者的免疫失衡。方法 收集活动性结核病患者 2 0例 ,其中肺结核 15例 ,淋巴结结核 5例 ;同时选取正常对照组 15例。应用流式细胞仪在单个核细胞水平检测结核病患者外周血和局部病灶Th细胞内的细胞因子。结果 结核病组 2 0例外周血中Th1 细胞较正常对照组普遍偏低 (P =0 0 0 0 ) ,而Th2 细胞较正常对照组无显著性差异 (P >0 0 5 )。其中 5例淋巴结结核患者淋巴结活检标本中的Th1 、Th2 细胞和正常对照组相比均无显著性差异 (P >0 0 5 ) ,和其外周血相比均有显著性差异 (P <0 0 5 )。结论 结核病的发生、发展与Th细胞亚群的失衡有密切关系 ,主要表现为Th1 细胞数量低下。结核患者的Th1 细胞低下主要表现在外周血 ,而局部病灶中的Th1 细胞并未减少。在外周血Th1 细胞低下的同时有Th2 细胞的增加。

Objective To determine the expression of INF-γ and IL-4 produced by Th cells in peripheral blood mononuclear cells (PBMC) and lymph node in patients with active tuberculosis, and to explore the immune imbalance in tuberculosis patients. Methods 20 patients including 15 patients with active pulmonary tuberculosis and 5 patients with active lymph node tuberculosis and 15 healthy volunteers were enrolled, and the blood specimens and lymph node tissue samples were obtained to determine the expression of INF-γ and IL-4 by flow cytometry. Results Th 1 cells in peripheral blood were significantly decreased in case group compared to control group (p=0.000), but Th 2 cells not (p>0.05). Between lymph node tuberculosis group and control group, there were no significant differences in Th 1 and Th 2 cells (p>0.05), but there were significant differences in peripheral blood (p<0.05). Conclusions Th 1/Th 2 imbalance may mediate the immunity response in tuberculosis infection, there may be close association between Th 1/Th 2 imbalance and the development of tuberculosis. Also, the decreased production of Th 1 cells may be mainly found in patients' PBMC but not in local focus, and the increase of Th 2 cells may follow with the decrease of Th 1 cells in patients' PMBC.