人类免疫缺陷病毒合并结核分枝杆菌感染者的抗结核细胞免疫功能
인류면역결함병독합병결핵분지간균감염자적항결핵세포면역공능
Study on Mycobacterium tuberculosis-specific cellular immunity in individuals co-infected with Mycobacterium tuberculosis and human immunodeficiency virus
  • 万方数据
    中华传染病杂志 중화전염병잡지
    CHINESE JOURNAL OF INFECTIOUS DISEASES
    2009年 8期 468-472 ,共5页

    许云亚%胡海燕%张舒%盛红%邵凌云%孟成艳%王莹%黄玲莉%王昀%张文宏

    허운아%호해연%장서%성홍%소릉운%맹성염%왕형%황령리%왕윤%장문굉

    HIV%分枝杆菌,结核%酶联免疫斑点技术%流式细胞术%免疫,细胞 HIV%分枝桿菌,結覈%酶聯免疫斑點技術%流式細胞術%免疫,細胞
    HIV%분지간균,결핵%매련면역반점기술%류식세포술%면역,세포
    HIV%Mycobacterium tuberculosis%Enzyme-linked immunospot assay%Flowcytometry%Immunity,cellular
    目的 评价HIV合并结核分枝杆菌潜伏感染或合并活动性结核患者的抗结核细胞免疫功能.方法 应用早期分泌性抗原靶蛋白(ESAT)-6和培养滤出蛋白(CFP)-10诱导的结核酶联免疫斑点法对云南地区100例明确诊断的HIV感染者的血液标本进行结核分枝杆菌特异性T淋巴细胞检测,同时应用流式细胞仪检测外周血CD3+CD4+T淋巴细胞和CD3+CD8+T淋巴细胞的绝对计数水平.采用Mann-Whitney检验进行非参数统计分析.结果临床上无活动性结核感染证据的HIV感染者中合并结核分枝杆菌潜伏感染的感染率高达67.6%.HIV合并结核分枝杆菌潜伏感染者的外周血CD3+CD4+T淋巴细胞(532×106/L)和CD3+CD8+T淋巴细胞(473×106/L)绝对计数与单纯HIV感染者(406×106/L和504 × 106/L)相比,差异无统计学意义.HIV合并活动性结核感染者的外周血CD3+CD4+T淋巴细胞绝对计数平均值为189 × 106/L,CD3+CD8+T淋巴细胞绝对计数平均值为293×106/L,均显著低于单纯HIV合并结核潜伏感染组和HIV组(U=168.0,U=163.0;U=147.0,U=374.0;均P<0.01).HIV合并活动性结核感染者的ESAT-6和CFP-10抗原特异性斑点形成细胞数(31/106细胞和82/106细胞)显著低于HIV合并结核分枝杆菌潜伏感染者(92/106细胞和109/106细胞.U=507.0,U=529.5,均P<0.01).结论 我国无活动性结核临床证据的HIV感染人群中有较高的结核潜伏感染率,HIV合并活动性结核感染者的总体细胞免疫应答功能及特异性抗结核免疫应答功能均严重受损.
    목적 평개HIV합병결핵분지간균잠복감염혹합병활동성결핵환자적항결핵세포면역공능.방법 응용조기분비성항원파단백(ESAT)-6화배양려출단백(CFP)-10유도적결핵매련면역반점법대운남지구100례명학진단적HIV감염자적혈액표본진행결핵분지간균특이성T림파세포검측,동시응용류식세포의검측외주혈CD3+CD4+T림파세포화CD3+CD8+T림파세포적절대계수수평.채용Mann-Whitney검험진행비삼수통계분석.결과림상상무활동성결핵감염증거적HIV감염자중합병결핵분지간균잠복감염적감염솔고체67.6%.HIV합병결핵분지간균잠복감염자적외주혈CD3+CD4+T림파세포(532×106/L)화CD3+CD8+T림파세포(473×106/L)절대계수여단순HIV감염자(406×106/L화504 × 106/L)상비,차이무통계학의의.HIV합병활동성결핵감염자적외주혈CD3+CD4+T림파세포절대계수평균치위189 × 106/L,CD3+CD8+T림파세포절대계수평균치위293×106/L,균현저저우단순HIV합병결핵잠복감염조화HIV조(U=168.0,U=163.0;U=147.0,U=374.0;균P<0.01).HIV합병활동성결핵감염자적ESAT-6화CFP-10항원특이성반점형성세포수(31/106세포화82/106세포)현저저우HIV합병결핵분지간균잠복감염자(92/106세포화109/106세포.U=507.0,U=529.5,균P<0.01).결론 아국무활동성결핵림상증거적HIV감염인군중유교고적결핵잠복감염솔,HIV합병활동성결핵감염자적총체세포면역응답공능급특이성항결핵면역응답공능균엄중수손.
    Objective To evaluate Mycobacterium tuberculosis (M. tuberculosis)-specific cellular immunity in individuals with latent or active tuberculosis and human immunodeficiency virus (HIV) coinfection. Methods One hundred HIV-infected individuals in Yunnan Province were enrolled. The enzyme-linked immunospot (ELISPOT) assay using early secreted antigenic target (ESAT)-6 and culture filtrate protein (CFP)-10 was employed to detect M. tuberculosis-specific T cells in the peripheral blood. The absolute number of CD3+ CD4+and CD3+ CD8+ T cells in the peripheral blood from the enrolled subjects were determined by flow cytometry. Data were analyzed using nonparametric Mann-Whitney test. Results The prevalence of latent tuberculosis co-infection in HIV-infected individuals without any clinical evidence of active tuberculosis was 67.6%. The absolute numbers of CD3+ CD4+ (532 × 106/L) and CD3+ CD8+ (473 × 106×/L) T cell in HIV-infected individuals with latent tuberculosis co-infection were similar to those of only HIV-infeeted individuals (406 ×106×/L and 504 × 106/L). While those in HIV-infected individuals with active tuberculosis co-infection were 189 × 106/L and 293 × 106/L, respectively, which were both significantly lower than those in other two groups (U=168. 0,U=163. 0,U= 374. 0,U=147. 0, all P<0. 01). Furthermore, ESAT-6 (31/106 cells) and CFP-10 (82/106 cells) specific spot-forming cells in HIV-infected individuals with active tuberculosis co-infection were significantly less than those in HIV-infected individuals with latent tuberculosis co-infection (92 × 106 cells and 109 × 106 cells, U= 507. 0,U= 529. 5, both P<0. 01). Conclusions The prevalence of latent tuberculosis in HIV-positive individuals without any clinical evidence of active tuberculosis is high in China. Both overall cellular immunity and M. tuberculosis-specific immune response in HIV-positive individuals with active tuberculosis co-infection are severely impaired.
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