【作者】 胥萍； 陈永井； 陈慧； 朱晓燕； 吴妹英； 吴敏娟； 张学光；

【Author】 XU Ping;CHEN Yong-Jing;CHEN hui;ZHU xiao-yan;WU Mei-Ying;WU Min-Juan;ZHANG Xue-Guang;Department of Medical Laboratory,No.5 Hospital of Suzhou;The Key Laboratory of Infection and Immunity;Institute of Medical Biotechnology,Soochow University;

【机构】 苏州市感染免疫重点实验室； 苏州大学医学生物技术研究所； 苏州市第五人民医院中心实验室；

【摘要】 目的分析肺结核患者外周血淋巴细胞表面PD-1/PD-L1表达特性,探讨其生物学意义。方法选择77例肺结核及并发症患者和29例健康志愿者,应用流式细胞术对外周血淋巴细胞和单核细胞表面PD-1/PD-L1的表达水平进行分析,应用统计学方法进行分析和比较。结果肺结核、肺结核并感染和肺结核并糖尿病患者外周血CD4⁺T细胞亚群比例分别为（44.18±3.29）%,（44.34±3.79）%和（39.11±9.51）%,与健康对照组（51.93±3.67）%之间具有显著性差异（p<0.01）;而各组患者CD8⁺T细胞比例分别为（56.44±3.19）%,（54.49±4.01）%和（59.44±10.15）%,与对照组（48.07±3.67）%之间存在显著差异性（p<0.05）;肺结核、肺结核并感染及肺结核并糖尿病患者外周血中CD4⁺CD25⁺T细胞亚群的比例均高于健康对照组;而CD4⁺D25^high细胞比例也均明显高于对照组（p<0.0001）;肺结核、肺结核并感染及肺结核并糖尿病患者CD8⁺T细胞表面均高表达PD-1,与对照组相比具有显著差异性（p<0.0001）;肺结核、肺结核并感染及肺结核并糖尿病患者的单核细胞表面PD-L1的表达量分别为（42.51±7.54）%,（49.42±6.29）%和（48.46±14.58）%,与对照组（17.91±3.03）%相比具有显著性差异（p<0.0001）。肺结核、肺结核并感染和肺结核并糖尿病患者的外周B细胞表面PD-L1也呈现明显的上调表达。结论 PD-1/PD-L1抑制途径可能与肺结核及其并发症的产生密切相关,参与调节减弱抗结核与抗感染免疫反应过程。更多还原

【Abstract】 Objective To analysis the expression of PD-1/PD-L1 on the lymphocytes in the patients with tuberculosis,and to explore the biological significance.Methods 77 cases of tuberculosis and complications patients and 29 healthy donors were enrolled in this study,immunostaining and flow cytometry was used to analysis PD-1/PD-L1 expression,the results and clinic data were analysised by the statistical methods.Results The results showed that the proportions of CD4+T cell subsets in the peripheral blood of tuberculosis,lung infections,44.18±3.29)%,（44.34±3.79）%and（39.11±9.51）%,while the healthy control group was（51.93±3.67）%,as compared to the controls it was significant difference（p<0.01）.The proportions of CD8+T cell in the patient groups,respectively,was（56.44 ±3.19）%,（54.49±4.01）% or（59.44±10.15）%,and it was significant differences when compared with the control group（48.07±3.67）%（p<0.05）.Both CD4+CD25+T cell and CD4+CD25^highcell subsets from the tuberculosis,tuberculosis and infections and tuberculosis and diabetes had much higher proportion than the healthy control group,and it had statistical significance as compared to the control group（p<0.0001）.The expression of PD-1 was upregulated on the surface of CD8+T cells in the groups of tuberculosis,tuberculosis and infections and tuberculosis and diabetes patients,and it was higher than that of the control group（p<0.0001）.The proportions of PD-L1 expression on the monocytes in each group was（42.51±7.54）%,（49.42±6.29）% and（48.46±14.58）%,and the difference compared to control group（17.91±3.03）% was significant（p<0.0001）.PD-L1 expression was also upregulated on B cells in each group and much higher than that of the control group.Conclusion PD-1/PD-L1 suppression pathway may be closely related to the development of tuberculosis and its complications involved in regulating weakened TB and anti-infection immune reaction process.更多还原