抗结核治疗中特异性T细胞免疫反应动态分析及其临床意义

发布时间：2018-04-12 18:50

本文选题：结核病 + Th细胞　；参考：《现代免疫学》2017年03期

【摘要】：目前,抗结核的化疗方案包括2个月的强化期与4个月的巩固期,而治疗过程中特异性细胞免疫应答随细菌载量改变呈现的动态变化特征有可能成为治疗疗效的生物标志物,并为个性化治疗方案提供理论依据。为此,我们收集了9例活动性结核病患者治疗前,治疗2、4、6个月的外周血样本,采用酶联免疫斑点测定法(enzyme-linked immune spot assay,ELISPOT)测定了不同治疗阶段结核特异性抗原ESAT-6和CFP-10刺激下PBMC中分泌IFN-γ的细胞数量,同时分析了抗原特异性Th1型细胞因子分泌水平以及多功能T细胞比例的动态变化特征。结果显示:随着治疗的深入,ESAT-6及CFP-10刺激患者PBMC后,释放IFN-γ的细胞数量显著下降(P0.05)。CD4~+IFN-γ~+T淋巴细胞的比例在治疗前与治疗6个月时相比有下降趋势,且治疗后结果具有归一性;虽然多功能T细胞有重要抗结核作用,但在我们统计的患者治疗过程中的变化不明显。以上结果表明抗结核治疗过程中外周淋巴细胞抗原特异性释放IFN-γ的细胞数量与CD4~+IFN-γ~+T淋巴细胞的比例随着患者的病情好转呈现下降趋势,提示抗原特异性细胞免疫应答的动态变化谱与病原菌负荷下降存在密切关系,可能成为抗结核治疗过程中的免疫学标志物。
[Abstract]:At present, the anti-tuberculosis chemotherapy regimen includes two months of intensive and four months of consolidation, and the dynamic characteristics of specific cellular immune response with the change of bacterial load in the course of treatment may become biomarkers of therapeutic efficacy.It also provides theoretical basis for individualized treatment.For this purpose, we collected peripheral blood samples from 9 active TB patients who were treated for 2, 6 months before treatment.Enzyme linked immune spot assay (Elisa) was used to determine the number of IFN- 纬 secreting cells in PBMC stimulated by tuberculosis specific antigen (ESAT-6) and CFP-10 in different stages of treatment.At the same time, the dynamic characteristics of antigen-specific Th1 cytokine secretion and multifunctional T cell ratio were analyzed.The results showed that with the further treatment of ESAT-6 and CFP-10 stimulation of PBMC, the number of IFN- 纬 -releasing cells decreased significantly. The percentage of P0.05 ~ CD4 ~ IFN- 纬 ~ T lymphocytes decreased before treatment compared with that at 6 months after treatment, and the results were normalized after treatment.Although multifunctional T cells have important antituberculous effects, the changes in the course of treatment in our statistics are not significant.These results suggest that the number of peripheral lymphocyte antigen specific IFN- 纬 release cells and the ratio of CD4- IFN- 纬 ~ T lymphocytes to CD4- IFN- 纬 ~ T lymphocytes decreased with the improvement of the patient's condition during anti-tuberculosis therapy.The results suggest that the dynamic spectrum of antigen-specific cellular immune response is closely related to the decrease of pathogen load, and may become an immunological marker in the course of anti-tuberculosis therapy.
【作者单位】：上海市免疫学研究所上海交通大学医学院;上海交通大学附属瑞金医院;
【基金】：“艾滋病和病毒性肝炎等重大传染病防治专项”(2013ZX10003007-003-003) 国家自然科学青年基金(81501361) 上海市免疫学研究所课题组长启动经费
【分类号】：R52

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