摘要
目的 分析结核性胸膜炎患者辅助T细胞 (Th)亚型Th1样细胞因子γ干扰素 (IFN γ)、白细胞介素 (IL) 2和Th2样细胞因子IL 4、IL 10在血清与胸腔积液中的分布特点 ,探讨系统及局部的Th1/Th2免疫应答在人类结核性胸膜炎病理生理过程中的可能作用。方法 应用夹心酶联免疫吸附测定 (ELISA)法检测 5 1例结核性胸膜炎患者 (胸膜炎组 )血清及胸液标本中IFN γ、IL 2、IL 4、IL 10的浓度 ,并与肺结核患者 (肺结核组 ,36例 )和健康人 (健康人组 ,2 4名 )比较。结果 (1) 3组受试者血清IFN γ、IL 2、IL 4、IL 10浓度中位数分别为 :胸膜炎组为 118 6 0ng/L、0 0 0ng/L、1 4 9ng/L、0 0 0ng/L ;肺结核组为 2 6 5 75ng/L、18 0 3ng/L、16 0 0ng/L、0 0 0ng/L ;健康人组为 2 2 1 70ng/L、18 5 2ng/L、16 0 0ng/L、0 0 0ng/L。 3组受试者血清IFN γ、IL 2浓度差异无显著性 (K W检验 χ2 值分别是 1 15、4 6 8,P >0 0 5 )。肺结核组和健康人组受试者血清IL 4、IL 10浓度差异无显著性 (Mann Whitney检验Z值分别为 - 0 2 7、- 1 93,P >0 0 5 ) ,结核性胸膜炎患者血清IL 4浓度明显低于肺结核组 (Mann Whitney检验Z值 - 2 84 ,P <0 0 1)。 (2 ) 3组受试者血清IFN γ与IL 4浓度之比依次为胸膜炎组 2 7 93,肺结?
Objective To evaluate the distribution characteristics of Th1-type cytokines (IFN-γ and IL-2) and Th2-type cytokines (IL-4 and IL-10) in the serum and the pleural effusion in patients with pleural tuberculosis,therefore to gain insight into the possible role of the local and the systemic Th1/Th2 cell-mediated immune response in the pathogenesis of human pleural tuberculosis. Methods The concentrations of IFN-γ,IL-2,IL-4,and IL-10 in the serum and the pleural effusion of patients with pleural tuberculosis (Group pleuritis) were measured with enzyme linked immuno-sorbent assay(ELISA). The serum levels of the four cytokines were compared with those of patients with pulmonary tuberculosis (Group tuberculosis) and of healthy controls with positive reaction to PPD skin test(Group healthy). Results (1)The median concentrations of IFN-γ,IL-2,IL-4,and IL-10 in serum were 118.60 ng/L,0.00 ng/L,1.49 ng/L,and 0.00 ng/L respectively in Group pleuritis,265.75 ng/L,18.03 ng/L,16.00 ng/L,and 0.00 ng/L respectively in Group tuberculosis;and 221.70 ng/L,18.52 ng/L,16.00 ng/L,and 0.00 ng/L respectively in Group healthy . (2)For IFN-γ and IL-2,there existed no statistical differences among the three groups (K-W χ 2 value was 1.15 and 4.68, P >0.05);For IL-4 and IL-10,there existed no statistical differences between Group tuberculosis and Group healthy (Mann-Whitney Z value was -0.27 and -1.93,P >0.05),but the level of IL-4 in Group pleuritis was lower than that in Group tuberculosis (Mann-Whitney Z value was -2.84,P <0.01).(3)The ratio of the median of IFN-γ to IL-4 in serum was 27.93 in Group pleuritis,21.72 in Group tuberculosis,and 10.82 in Group healthy respectively. There existed no statistical difference among the three groups(K-W χ 2 value was 4.18, P >0.05). (4)The median concentrations of IFN-γ,IL-2,IL-4,and IL-10 in pleural effusion of Group pleuritis were 823.37 ng/L,43.76 ng/L,26 ng/L and 38.69 ng/L respectively,each being statistically higher than that in the serum(Wilcoxon Signed Rank test Z value was -4.34、-2.82、-3.29 and -5.15, P <0.05 ).Conclusions Immunocompetent persons including patients with pleural tuberculosis,with pulmonary tuberculosis or the healthy with positive results to PPD test,showed similar systemic Th1 response to Mycobacterium baccili . Due to the relatively lower level of systemic Th2 response,patients with pleural tuberculosis had higher systemic Th1/Th2 level and the enhancement of local Th1 and Th2 responses in the pleural cavity was a pathophysiologic characteristic of human pleural tuberculosis. Both Th1 and Th2 responses might play an important role in the pathogenesis of human pleural tuberculosis.
出处
《中华结核和呼吸杂志》
CAS
CSCD
北大核心
2004年第5期324-327,共4页
Chinese Journal of Tuberculosis and Respiratory Diseases
关键词
TH1/TH2
免疫应答系统
结核性胸膜炎
表达
Tuberculosis,pleural
T-lymphocytes,helper-inducer
Interferon typeⅡ
Interleukins
