中华传染病杂志
中華傳染病雜誌
중화전염병잡지
CHINESE JOURNAL OF INFECTIOUS DISEASES
2014年
7期
30-35
,共6页
何纲%丁佩佩%甄沛林%伍金华%李秀娟%汤志强%胡长征%吴兴柳%陈晓华%唐小平
何綱%丁珮珮%甄沛林%伍金華%李秀娟%湯誌彊%鬍長徵%吳興柳%陳曉華%唐小平
하강%정패패%견패림%오금화%리수연%탕지강%호장정%오흥류%진효화%당소평
结核, 肺%程序性死亡分子 1%T 淋巴细胞
結覈, 肺%程序性死亡分子 1%T 淋巴細胞
결핵, 폐%정서성사망분자 1%T 림파세포
Tuberculosis,pulmonary%PD-1%T-lymphocytes
目的:探讨程序性死亡分子1(PD-1)在肺结核患者细胞免疫机制中的作用及意义。方法收集中山大学附属江门市中心医院及江门市结核病防治所2011年7月至2012年7月住院药物敏感(DS)肺结核初治患者20例(DS 组)、住院耐多药(DR)肺结核患者15例(DR 组),另外选取江门市中心医院同期健康体格检查者26名作为健康对照组。使用流式细胞仪测量治疗前、治疗3个月时的CD4+、CD8+ T 淋巴细胞上 PD-1的表达及γ干扰素水平,并进行对比分析。多个独立样本的计量资料或等级资料的比较采用 Kruskal-Wallis H 检验,配对样本的比较采用 Wilcoxon signed-rank 检验;相关性分析采用 Pearson 检验。结果治疗后,DS 组(CD4+ T 淋巴细胞:15.99%比21.59%;CD8+ T 淋巴细胞:11.86%比18.52%)、DR 组(CD4+ T 淋巴细胞:26.64%比35.47%;CD8+ T 淋巴细胞:29.64%比34.56%)PD-1阳性表达率均较治疗前明显下降,差异有统计学意义(均 P<0.05);DS 组γ干扰素水平较治疗前显著升高(50.65 ng/L 比32.31 ng/L ),差异有统计学意义( P <0.01),DR 组治疗前后(22.26 ng /L比20.03 ng /L)差异无统计学意义(P >0.05)。 DS 组治疗前及治疗后 CD4+ T 淋巴细胞PD-1阴性表达率与γ干扰素水平均呈负相关(治疗前:r =-0.510;治疗后:r =-0.520;均 P<0.05)。结论 PD-1对 DS 患者的 T 淋巴细胞功能有调节作用,尤其在 CD4+ T 淋巴细胞所介导的细胞免疫中扮演关键角色。但 DR 肺结核的细胞免疫调节机制可能更加复杂。
目的:探討程序性死亡分子1(PD-1)在肺結覈患者細胞免疫機製中的作用及意義。方法收集中山大學附屬江門市中心醫院及江門市結覈病防治所2011年7月至2012年7月住院藥物敏感(DS)肺結覈初治患者20例(DS 組)、住院耐多藥(DR)肺結覈患者15例(DR 組),另外選取江門市中心醫院同期健康體格檢查者26名作為健康對照組。使用流式細胞儀測量治療前、治療3箇月時的CD4+、CD8+ T 淋巴細胞上 PD-1的錶達及γ榦擾素水平,併進行對比分析。多箇獨立樣本的計量資料或等級資料的比較採用 Kruskal-Wallis H 檢驗,配對樣本的比較採用 Wilcoxon signed-rank 檢驗;相關性分析採用 Pearson 檢驗。結果治療後,DS 組(CD4+ T 淋巴細胞:15.99%比21.59%;CD8+ T 淋巴細胞:11.86%比18.52%)、DR 組(CD4+ T 淋巴細胞:26.64%比35.47%;CD8+ T 淋巴細胞:29.64%比34.56%)PD-1暘性錶達率均較治療前明顯下降,差異有統計學意義(均 P<0.05);DS 組γ榦擾素水平較治療前顯著升高(50.65 ng/L 比32.31 ng/L ),差異有統計學意義( P <0.01),DR 組治療前後(22.26 ng /L比20.03 ng /L)差異無統計學意義(P >0.05)。 DS 組治療前及治療後 CD4+ T 淋巴細胞PD-1陰性錶達率與γ榦擾素水平均呈負相關(治療前:r =-0.510;治療後:r =-0.520;均 P<0.05)。結論 PD-1對 DS 患者的 T 淋巴細胞功能有調節作用,尤其在 CD4+ T 淋巴細胞所介導的細胞免疫中扮縯關鍵角色。但 DR 肺結覈的細胞免疫調節機製可能更加複雜。
목적:탐토정서성사망분자1(PD-1)재폐결핵환자세포면역궤제중적작용급의의。방법수집중산대학부속강문시중심의원급강문시결핵병방치소2011년7월지2012년7월주원약물민감(DS)폐결핵초치환자20례(DS 조)、주원내다약(DR)폐결핵환자15례(DR 조),령외선취강문시중심의원동기건강체격검사자26명작위건강대조조。사용류식세포의측량치료전、치료3개월시적CD4+、CD8+ T 림파세포상 PD-1적표체급γ간우소수평,병진행대비분석。다개독립양본적계량자료혹등급자료적비교채용 Kruskal-Wallis H 검험,배대양본적비교채용 Wilcoxon signed-rank 검험;상관성분석채용 Pearson 검험。결과치료후,DS 조(CD4+ T 림파세포:15.99%비21.59%;CD8+ T 림파세포:11.86%비18.52%)、DR 조(CD4+ T 림파세포:26.64%비35.47%;CD8+ T 림파세포:29.64%비34.56%)PD-1양성표체솔균교치료전명현하강,차이유통계학의의(균 P<0.05);DS 조γ간우소수평교치료전현저승고(50.65 ng/L 비32.31 ng/L ),차이유통계학의의( P <0.01),DR 조치료전후(22.26 ng /L비20.03 ng /L)차이무통계학의의(P >0.05)。 DS 조치료전급치료후 CD4+ T 림파세포PD-1음성표체솔여γ간우소수평균정부상관(치료전:r =-0.510;치료후:r =-0.520;균 P<0.05)。결론 PD-1대 DS 환자적 T 림파세포공능유조절작용,우기재 CD4+ T 림파세포소개도적세포면역중분연관건각색。단 DR 폐결핵적세포면역조절궤제가능경가복잡。
Objective To investigate the expression and significance of programmed death-1 (PD-1) in cellular immune response of patients with tuberculosis (TB) infection .Methods Twenty drug-sensitive (DS) and fifteen drug-resistant (DR ) subjects with TB infection who were hospitalized in Jiangmen Central Hospital affiliated Sun Yat-Sen University and Jiangmen tuberculosis dispensary from July 2011 to July 2012 were included in this study . Twenty-six healthy subjects were included as control . The expressions of PD-1 on CD4 + and CD8 + T lymphocytes were measured using flow cytometry and plasma interferon-γ (IFN-γ) ,levels were analyzed before and after TB treatment for 3 months .Kruskal-Wallis H test was used for analysis of multiple independent samples and Wilcoxon signed-rank test was used for analysis of paired samples . Pearson test was used for correlation analysis . Results After anti-TB chemotherapy ,the expressions of PD-1 on CD4 + and CD8 + T cells in both TB groups were significantly decreased (DS group :15 .99% vs 21 .59% and 11 .86% vs 18 .52% ;DR group :26 .64% vs 35 .47% and 29 .64% vs 34 .56% ) (both P < 0 .05) .Plasma IFN-γ level in DS group increased significantly after treatment(50 .65 ng/L vs 32 .31 ng/L , P < 0 .01) ,while that in DR group did not increase significantly (22 .26 ng/L vs 20 .03 ng/L ,P> 0 .05) .In DS group ,the expression of PD-1 on CD4 + T lymphocytes was negative correlated with plasma IFN-γ level both before and after anti-TB chemotherapy (pre-treatment : r = - 0 .510 , P < 0 .05 ; post-treatment : r = - 0 .520 , P< 0 .05 ) . Conclusions PD-1 modulates T cell function of immune response against TB infection in DS-TB subjects and plays a key regulatory role in CD4 + T lymphocyte mediated immunity during TB infection . However , the immunomodulatory mechanism of cell immunity in DR-TB subjects may be more complex .