结核患者外周血中辅助性T细胞17及白细胞介素-17水平的变化

目的:探讨结核患者外周血辅助性T细胞17(Th17细胞)及白细胞介素-17(IL-17)水平变化及意义。方法:以结核患者98例(初治58例,复治40例)、健康对照者98例为研究对象,抽取研究对象外周血并分离外周血单核细胞(PBMC)和血浆,采用流式细胞术(FCM)检测PBMC中Th17细胞的百分率,酶联免疫吸试验(ELISA)检测血浆中IL-17水平;用灭活的结核分枝杆菌菌株(H37Rv)分别刺激结核患者和健康对照者PBMC,ELISA法检测其上清中IL-17水平。结果:与健康对照者比较,结核患者外周血Th17细胞比例(5.2±1.8)%vs(1.8±1.4)%,P<0.05]及IL-17水平(68.22±10.31)vs(39.81±14.58)pg/ml,P<0.01]显著增高;与初治组比较,复治组Th17细胞比例(6.4±1.8)%vs(3.8±1.3)%,P<0.05]及IL-17水平(85.46±9.13)vs(51.22±12.36)pg/ml,P<0.05]显著增高;结核患者血浆IL-17水平与Th17细胞的比例呈正相关(r=0.912,P<0.05);H37RV刺激结核病人和健康对照者PBMC后上清中均有IL-17的表达,且结核病人来源的表达水平更高。结论:结核患者外周血Th17细胞比例及IL-17水平增高,Th17细胞和IL-17在结核病的发生发展中发挥了重要作用。

Levels of Th17 cells and IL-17 in tuberculosis patient's peripheral blood

Objective : To investigate the changes and clinical significance of Th17cells and IL-17levels in tuberculosis(TB) patient's peripheral blood.Methods : The study involved 98TB patients(58initial treatment patients,40re-treatment patients) and 98healthy controls.Peripheral blood mononuclear cell(PBMC) and plasma derived from their peripheral blood were tested.Flow cytometry was used to determine the percentage of Th17cells in PBMC,enzyme-linked immunosorbent assay(ELISA) was used to determine the levels of IL-17in plasma;TB patients and healthy controls'PBMC were infected with heat-inactivated mycobacterium tuberculosis(M.tb) H37Rv,the levels of IL-17in supernatant of PBMCs were measured by ELISA.Results : To compare with the healthy controls,the percentages of Th17cells in TB patients'peripheral blood were significantly increased (5.2±1.8) %vs(1.8±1.4) %,P<0.05 ];the levels of IL-17in TB patient's plasma were significantly higher than that in healthy controls (68.22±10.31) vs(39.81±14.58) ng / L,P<0.01 ].In addition,compared with initial treatment patients,the percentages of Th17cells (6.4 ±1.8) % vs(3.8±1.3) %,P<0.05 ] and IL-17levels (85.46±9.13) vs(51.22±12.36) ng / L,P<0.05 ] in re-treatment patients were significantly increased.The levels of IL-17and the percentages of Th17cells were positively correlated(r=0.912,P<0.05);IL-17in the supernatant of TB patients and healthy controls' PBMC infected with M.tb H37Rv were expressed,relatively high levels were from TB patients'supernatant.Conclusion : The percentages of Th17cells and the levels of IL-17in TB patient's peripheral blood are significantly increased compared with healthy controls,Th17cells and IL-17play important roles in the initiation and progression of TB.