论文部分内容阅读
目的探讨肺结核患者结核分支杆菌EIS抗原特异性细胞免疫水平与病情的关系。方法选择30例初治、痰涂片结核杆菌阳性的活动性肺结核患者,采用比色法测定其外周血淋巴细胞对结核分支杆菌EIS抗原的增殖反应,酶联免疫吸附法测定细胞分泌的γ干扰素(IFNγ)及白细胞介素10(IL10)的水平,并与20名健康对照者和16例康复的肺结核患者进行比较。结果康复者对EIS的细胞免疫最为强烈,其外周血淋巴细胞的细胞增殖强度显著高于健康对照者和活动性肺结核患者(P均<0.01)。活动性肺结核患者外周血淋巴细胞在受到EIS刺激时分泌的IFNγ显著低于康复者(P<0.05)。EIS抗原刺激主要诱导细胞分泌Th2型细胞因子IL10。结论活动性肺结核患者对EIS抗原的细胞免疫水平低下,经抗结核治疗康复后,细胞免疫维持在较高水平。EIS抗原诱导Th1/Th2免疫失衡可能是EIS参与结核发病的机制之一。
Objective To investigate the relationship between the level of EIS antigen-specific cellular immunity and the severity of Mycobacterium tuberculosis in patients with pulmonary tuberculosis. Methods Thirty patients with active pulmonary tuberculosis who were newly diagnosed and sputum smear-positive Mycobacterium tuberculosis were selected. The proliferative responses of their peripheral blood lymphocytes to EIS antigen of Mycobacterium tuberculosis were determined by colorimetric assay. The γ-interference of cells secreted by enzyme-linked immunosorbent assay (IFNγ) and interleukin 10 (IL10) were measured and compared with 20 healthy controls and 16 patients with rehabilitated pulmonary tuberculosis. Results The patients with EIS had the strongest cellular immunity. The cell proliferation of peripheral blood lymphocytes was significantly higher than that of healthy controls and active tuberculosis patients (all P <0.01). The activity of IFNγ secreted by peripheral blood lymphocytes of patients with active pulmonary tuberculosis stimulated by EIS was significantly lower than that of recovered patients (P <0.05). EIS antigen stimulation mainly induces secretion of Th2 cytokine IL10. Conclusions Active tuberculosis patients have low level of cellular immune response to EIS antigen. After anti-TB therapy, cellular immunity is maintained at a high level. EIS antigen induced Th1 / Th2 immune imbalance may be involved in the pathogenesis of EIS tuberculosis.