马尔尼菲篮状菌感染组织中巨噬细胞表型分析

发布时间：2018-10-26 18:59

【摘要】：目的分析马尔尼菲篮状菌感染组织中巨噬细胞极化与组织病理学改变以及临床表现的联系,初步探讨马尔尼菲篮状菌逃脱宿主免疫防御的机制。方法收集16例HIV(-)的马尔尼菲篮状菌病患者皮损组织蜡块和10例马尔尼菲篮状菌感染小鼠皮肤、肺、肝、脾组织蜡块。组织蜡块行HE染色,分析感染组织炎症反应模式,通过免疫组化技术检测感染组织巨噬细胞CD86、CD163、Arg-1的表达情况。回顾性分析16例HIV(-)的马尔尼菲篮状菌病患者的临床资料,分析巨噬细胞极化状态与临床表现的关系。结果1.16例HIV(-)马尔尼菲篮状菌病患者皮损组织病理表现为化脓性炎10例(62.50%)、化脓性炎并肉芽肿性炎5例(31.35%),坏死性炎1例(6.25%);炎症为混合炎细胞(中性粒细胞、嗜酸性粒细胞、浆细胞、淋巴细胞、巨噬细胞)浸润。10例小鼠感染组织均表现为化脓性炎和肉芽肿性炎;炎症为混合炎细胞(中性粒细胞、浆细胞、淋巴细胞、巨噬细胞)浸润,炎细胞中无嗜酸性粒细胞。2.16例HIV(-)的马尔尼菲篮状菌病患者皮损组织巨噬细胞CD163均表达,7例CD86表达(43.75%),1例Arg-1表达(6.25%)。10例马尔尼菲篮状菌感染小鼠组织(皮肤、肝脏、肺脏、脾脏)均表达CD86、CD163、Arg-1。3.马尔尼菲篮状菌感染的人CD86/CD163的光密度比值中位数(四分位数)为0.00(0.00,0.51),马尔尼菲篮状菌感染的小鼠组织中巨噬细胞CD86/CD163的光密度比值平均值为1.71±1.91,两者比较差异有统计学意义(p0.05)。CD86阳性表达患者组外周血淋巴细胞计数平均值为3.01±0.94,CD86无表达患者组外周血淋巴细胞计数平均值为1.87±1.05,两者比较差异有统计学意义(p0.05)。结论HIV(-)患者感染马尔尼菲篮状菌,皮损组织中巨噬细胞极化可能存在失平衡,巨噬细胞倾向于被诱导向M2型极化。
[Abstract]:Objective to analyze the relationship between macrophage polarization, histopathological changes and clinical manifestations in the infected tissues of Bacillus marneffei, and to explore the mechanism of immune defense of the host. Methods paraffin lumps were collected from 16 cases of HIV (-) and 10 cases of infected mice skin, lung, liver and spleen tissues from HIV (-) patients. HE staining was used to analyze the inflammatory response pattern of infected tissues and the expression of CD86,CD163,Arg-1 in macrophages was detected by immunohistochemical technique. The clinical data of 16 HIV (-) patients with Marnefi's disease were analyzed retrospectively and the relationship between macrophage polarization and clinical manifestations was analyzed. Results 1.The histopathological features of 16 cases of HIV (-) Marnefi's bacillariasis were suppurative inflammation in 10 cases (62.50%), suppurative inflammation with granulomatous inflammation in 5 cases (31.35%) and necrotizing inflammation in 1 case (6.25%). The inflammatory cells (neutrophils, eosinophils, plasma cells, lymphocytes, macrophages) infiltrated into the mixed inflammatory cells. The infection tissues of 10 mice showed suppurative inflammation and granulomatous inflammation. Inflammatory cells (neutrophilic granulocytes, plasma cells, lymphocytes, macrophages) infiltrated, and no eosinophilic granulocytes were found in the inflammatory cells. 2. The CD163 expression of macrophages in the lesions of patients with HIV (-) was observed. 7 cases (43.75%) expressed CD86, 1 case (6.25%) expressed Arg-1. 10 cases (skin, liver, lung, spleen) of mice infected with Bacillus marneffei expressed CD86,CD163,Arg-1.3.. The median optical density ratio (four quartiles) of human CD86/CD163 infected by Bacillus marneffei was 0.00 (0.000. 51). The average optical density ratio of CD86/CD163 in macrophages was 1.71 卤1.91 in mice infected with Bacillus marneffei. There was a significant difference between the two groups (p0.05). The mean value of peripheral blood lymphocyte count in patients with CD86 positive expression was 3.01 卤0.94 + CD86 and 1.87 卤1.05 in patients without CD86 expression. The difference was statistically significant (p 0.05). Conclusion if HIV (-) patients are infected with Bacillus marneffei, the polarization of macrophages may be out of balance in the lesions, and macrophages tend to be induced to M2 polarization.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R519

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