CAJ | 학술논문

目的：比较初发隐球菌性脑膜炎患者治疗前后与健康对照人群外周血 CD4＋ T 细胞中 Th9和 Th17细胞的比值，探讨 Th9和 Th17细胞在隐球菌性脑膜炎发病机制中的作用。方法选取初发未经治疗隐球菌性脑膜炎患者及健康对照各12例，抽取隐球菌性脑膜炎患者治疗前和治疗后3周及健康对照的外周血，分离外周血单核细胞，应用流式细胞仪检测技术对3组病例外周血 CD4＋ T 细胞中 Th9和 Th17的比值进行比较。结果与健康对照相比，隐球菌性脑膜炎患者治疗前Th17表达下调，差异有统计学意义；在治疗好转患者中，治疗后 Th17表达显著上调，与治疗前及健康对照相比差异均有统计学意义。Th9在治疗前与健康对照相比无差异，在治疗后隐球菌性脑膜炎患者中表达上调。结论 Th17免疫途径是隐球菌性脑膜炎患者抵御隐球菌感染的重要免疫机制，隐球菌性脑膜炎发病及治疗拮抗可能与 Th17缺乏有关。
목적：비교초발은구균성뇌막염환자치료전후여건강대조인군외주혈 CD4＋ T 세포중 Th9화 Th17세포적비치，탐토 Th9화 Th17세포재은구균성뇌막염발병궤제중적작용。방법선취초발미경치료은구균성뇌막염환자급건강대조각12례，추취은구균성뇌막염환자치료전화치료후3주급건강대조적외주혈，분리외주혈단핵세포，응용류식세포의검측기술대3조병예외주혈 CD4＋ T 세포중 Th9화 Th17적비치진행비교。결과여건강대조상비，은구균성뇌막염환자치료전Th17표체하조，차이유통계학의의；재치료호전환자중，치료후 Th17표체현저상조，여치료전급건강대조상비차이균유통계학의의。Th9재치료전여건강대조상비무차이，재치료후은구균성뇌막염환자중표체상조。결론 Th17면역도경시은구균성뇌막염환자저어은구균감염적중요면역궤제，은구균성뇌막염발병급치료길항가능여 Th17결핍유관。
Objective To explore the role of Th9 and Th17 cells in the pathogenesis of CM by mesureing the ratio of Th9 and Th17 cells in CD4 + T lymphocyte of patients with cryptococcal meningitis(CM). Methods Twelve CM patients without antifungal treatment and 12 healthy controls were selected. The peripheral blood was collected from patients prior treatment and three weeks af-ter treatment and the healthy controls. The ratio of Th9 and Th17 cells in peripheral blood were analyzed by flow cytometry. Result The ratio of Th17 cells in patients with CM before treatment was less than those of healthy people,and patients who received treat-ment showed the increased level of Th17 cells which was higher than those in patients before treatment and the healthy controls. The ratioof Th9 also increased in the patients who received treatment while there was no significant different between the patients before treatment and the healthy controls. Conclusion Th17 immune pathway is an important immune mechanism against Cryptococcus in-fection in patients with CM. The lack of Th17 cells may play a role in the pathogenesis and treatment-resistant of CM.