结核病与肿瘤坏死因子和白细胞介素的相关性研究

目的研究3种白细胞介素IL-12I、L-18I、L-10和肿瘤坏死因子α(TNF-α)、转化生长因子-β(TGF-β)在结核病免疫发病机制中的作用,为开发新的疫苗和发展免疫疗法提供依据。方法用双抗体夹心酶联免疫吸附试验(ELISA)及素化酶复化物(生物素-亲和素双抗夹心)ABC-ELISA试剂盒检测39例结核性胸膜炎患者胸腔积液和血清中以上5种细胞因子的水平,并进行相关性分析。对治疗过程中10例结核病Ⅲ型和5例Ⅳ型患者X线胸片提示进展期到好转期上述细胞因子在胸腔积液中的变化进行观测。结果对每组、每型的分析发现,从总体来看,除IL-18外,IL-12、TNF-αI、L-10胸腔积液中含量均远远超过血清中含量,而值得注意的是转化生长因子β1血清中含量远远超过胸腔积液中含量,差异有统计学意义(P<0.05或P<0.01)。结论 IL-18可以作为加强疫苗保护性的一种辅助因子;各组、各型患者胸腔积液中上述细胞因子的相关性分析结果可为结核病免疫发病机制的研究提供参考;开展对治疗好转结核病的免疫治疗时应综合考虑机体的免疫状态,某种细胞因子的作用不是对所有患者都有效,与体内细胞因子间的平衡有关。

Study of relationship between tuberculous with interleukins and TNF

Objective To study the role of three kinds of interleukins IL-12,IL-18 and IL-10 and two kinds of cytokines TNF-α and TGF-β1 in the immunopathogenesis of tuberculosis to provide evidence for designing new vaccine and developing immunotherapy.Methods The concentration of IL-12,IL-18,TNF-α and TGF-β1 and IL-10 in pleural fluid（PF） and serum were measured by sandwich ABC-ELISA and sandwich double antibody ELISA Kits in 39 cases of tuberculosis pleural effusion and analysed their correlation.The changes of these cytokines were observed during the course from progression to resolving stage showed by X-ray in 10 cases of type Ⅲ and 5 cases of type Ⅳ.Results Except IL-18,the other cytokines were far higher in PF than in serum;the level of TGF-β was higher in serum than in PF（P 0.05 or P 0.01）.Conclusion IL-18 perhaps could be used as a adjuvant agent to enhance the efficacy of vaccine,which could be considered to design a new vaccine.The results of correlation with these cytokines could be used to help the study of immunopathogenesis in tuberculosis.Through the observation of these cytokines in the course of therapy,it might be important to consider the immune situation synthetically,because the role of a certain cytokine related with the balance of cytokine network is not effective in all patients.