摘要
目的 分析耐多药肺结核患者自身T淋巴细胞表达和PD-1之间的关系。方法 选取对异烟肼、利福平耐药的患者为HR耐药组，对异烟肼、利福平敏感的患者为HR敏感组，健康人群为健康组。采集外周血，运用流式细胞检测技术对其进行T淋巴细胞、CD8+表面PD-1受体的检测。结果 分析机体淋巴细胞CD4+表达情况为：HR耐药组与HR敏感组（P=0.016）；HR耐药组以及健康分析组之间的数据比较，对应p<0.05；且HR敏感组以及健康分析组之间的数据比较，对应p<0.05。针对机体淋巴细胞CD8+表达情况为：HR耐药组与HR敏感组（P=0.012）；HR耐药组与健康分析组（P<0.001）；HR敏感组与健康分析组（P=0.001）。结论 HR耐药相关的肺结核检验中，T淋巴细胞CD4+、和T淋巴细胞CD8对应的PD-1受体均较HR敏感类型患者、健康群体的受体水平高。
关键词： 耐多药肺结核；淋巴细胞亚群；PD-1受体
Abstract
Objective: To analyze the relationship between self T lymphocyte expression and PD-1 in multidrug-resistant pulmonary TB patients. Methods: Patients resistant to isoniazid and rifampin were selected as the HR resistant group, patients sensitive to isoniazid and rifampin were selected as the HR sensitive group, and the healthy population was the healthy group. Peripheral blood was collected and tested for T lymphocytes and CD8 + PD-1 surface receptor by flow cytometry technology. Results: CD4 + expression of lymphocytes was: HR resistant and HR sensitive groups (P=0.016); data comparison between HR resistant and healthy analysis groups, corresponding to p <0.05; and data comparison between HR sensitive and healthy analysis groups, corresponding p <0.05. CD8 + expression of lymphocytes of the body was: HR resistant and HR sensitive group (P=0.012); HR resistant and healthy analysis group (P <0.001); and HR sensitive group and health analysis group (P=0.001). Conclusion : In the pulmonary tuberculosis test of HR resistance, PD-1 receptors corresponding to CD4 + of T lymphocytes and CD8 were higher than those of HR sensitive patients and healthy groups.
Key words： Multidrug-resistant tuberculosis, Lymphocyte subsets, PD-1 Receptor
参考文献 References
[1] Flynn JL, Chan J. Immune evasion by Mycobacterium tuberculosis:living with the enemy [J ].Curropin immunol, 2003, 15 (4): 450-455.
[2] Bardhan K, Anagnostou T, Boussiotis VA. The PD1: PD-L1/2 pathway from discovery to clinical implementation[J]. Front Immunol, 2016, 7 (1) :550.
[3] Rota G, Niogret C, Dang AT, et al. Shp-2 is dispensable for establishing T cell exhaustion and for PD-1 signaling in vivo[J]. Cell Rep, 2018, 23 (1) :39.
[4] Boussiotis VA. Molecular and biochemical aspects of the PD-1 checkpoint pathway[J]. N Engl J Med, 2016, 375 (18) :1767.
[5] 中华人民共和国卫生部.肺结核诊断（ws288-2017).北京：人民卫生出版.2018.
[6] 何纲,丁佩佩,甄沛林,等. 程序性死亡分子1在药物敏感及耐多药肺结核患者T淋巴细胞上的表达及意义[J]. 中华传染病杂志,2014(7):30-35.
[7] 巫丽兰. PD-1在耐多药肺结核患者T淋巴细胞亚群的表达及意义[D]. 广州医科大学,2019.
[8] 王丽,熊坤龙,朱长太,等. T淋巴细胞耗竭在耐多药肺结核患者免疫表达中的初步研究[J]. 中国防痨杂志,2021,43(8):808-812.
[9] 赵霞,孙会,王建新,等. 茜草配方颗粒辅助治疗耐多药肺结核患者的临床效果[J]. 中华医院感染学杂志, 2021, 31(10): 1451-1455.
[10] 宫雯雯,王天琳,肖燕,等. PD-1/PD-L1抑制剂相关垂体炎临床特征分析并文献复习[J]. 中华内分泌代谢杂志,2024,40(4):298-304.
[11] 张海莲. Hp 感染萎缩性胃炎胃黏膜中 T 淋巴细胞亚群及 PD-1 表达的意义[D].蚌埠医学 院,2017.
[12] 彭丽珊,冷静,刘显,等.HIV-1 感染者 CD4+CD127-T 细胞减少与 PD-1 高表达相关[J]. 免疫 学杂志, 2018, 34(10): 886-893.