结核分枝杆菌肝素结合血凝素在肺结核及肺外结核中的免疫作用研究

目的探讨结核分枝杆菌肝素结合血凝黏附素（heparin-binding hemagglutinin adhesin, HBHA）在不同结核感染状态人群中免疫反应及可能的诊断价值。 方法用天然的HBHA刺激选取阴性对照、潜伏感染者、肺结核和肺外结核患者，分离外周血单个核细胞，加入共培养，收集细胞培养上清，ELISA方法检测上清中IFN-γ的浓度，运用非参数检验的方法统计分析。结果4组HBHA特异的IFN-γ分泌水平分别为49.5、781.9、341.8、214.4pg/ml，潜伏感染者组远高于其他各组，HBHA 刺激后肺结核和肺外结核之间的IFN-γ分泌水平无统计学差异（U＝1901.5，P＝0.448）。结论HBHA特异的IFN-γ分泌水平，有利于鉴别健康人群中的潜伏感染者，HBHA可能具有一定的免疫保护作用，尽管HBHA与肺外结核发病相关，其特异的细胞免疫在肺结核和肺外结核间无统计学差异。

Immune effect of heparin-binding hemagglutinin adhesin on pulmonary tuberculosis and extra-pulmonary tuberculosis

Objective To investigate the immune effect of heparin-binding hemagglutinin adhesin （HBHA） on different states of tuberculosis infection and its diagnosis value. Methods Native HBHA were used to stimulate peripheral blood mononuclear cells （PBMCs） from the different cases including negative control, latent tuberculosis （LTB）, pulmonary tuberculosis, and extra-pulmonary tuberculosis, the interferon-gamma （IFN-γ） in the supernatant of culture was detected by ELISA method. Nonparametric test was used to analyse the data. Results The median level of HBHA- specific IFN-γ in the four groups were 49.5 pg/ml, 781.9 pg/ml, 341.8 pg/ml, 214.4 pg/ml, respectively. The IFN-γ level in LTB group was higher than other groups. The IFN-γ level in pulmonary tuberculosis group and extra-pulmonary tuberculosis group after stimulation with HBHA showed no significant difference （U=1 901.5,P=0. 448）. Conclusions HBHA-speeific IFN-g release may identify tuberculosis infection cases from normal cases.