【摘要】：研究背景：在宿主對結(jié)核分枝桿菌（Mtb）感染的免疫機(jī)制中，γδ T細(xì)胞的作用越來越受到關(guān)注和重視。近年研究報道Mtb和卡介苗感染的小鼠模型中分泌IL-17的細(xì)胞主要來源于γδ T細(xì)胞。本研究室近期的研究也發(fā)現(xiàn)活動性肺結(jié)核（TB）患者外周血中產(chǎn)生IL-17的γδ T細(xì)胞（Tγδ17細(xì)胞）的比例明顯高于正常健康人。但Tγδ17細(xì)胞是屬于γδ T細(xì)胞的何種亞群，以及肺TB患者的Tγδ17細(xì)胞的亞群類別與健康人有何不同，均尚未見報道。另外，雖然對于誘導(dǎo)Th17細(xì)胞分化的關(guān)鍵性細(xì)胞因子和轉(zhuǎn)錄因子已經(jīng)明確，但是對于誘導(dǎo)Tγδ17細(xì)胞分化的細(xì)胞因子，轉(zhuǎn)錄因子和抗原的調(diào)節(jié)作用等影響因素的研究很少，尚有待探討闡明。 目的：檢測TB患者和健康人（HD）外周血中Tγδ17細(xì)胞屬于γδ T細(xì)胞何種亞群（Vδ1、Vδ2及Vδ3-8亞群）探討肺TB患者的Tγδ17細(xì)胞的亞群類別與健康人有何不同,以及結(jié)核桿菌（M.tb）耐熱抗原（Mtb-HAg）、磷酸化抗原（HDMAPP）加入細(xì)胞因子誘導(dǎo)Tγδ17細(xì)胞分化有何不同，以探討不同淋巴細(xì)胞亞群在抗M.tb感染免疫應(yīng)答和TB發(fā)病機(jī)制中的作用。 方法：1.采集70例活動性肺結(jié)核病人、100例HD和33例矽肺患者外周血，加入熒光標(biāo)記單抗進(jìn)行表面分子染色，流式細(xì)胞儀檢測γδT細(xì)胞亞群（Vδ1、Vδ2及Vδ3-8亞群）的比例變化。2.采集24例活動性肺結(jié)核病人和17例HD外周血，加入佛波醇酯（PMA）和鈣離子霉素（Ionomycin）刺激培養(yǎng)2小時后，再加入莫能霉素（Monensin）繼續(xù)培養(yǎng)4小時，收集細(xì)胞，加入熒光標(biāo)記單抗進(jìn)行表面分子和胞內(nèi)染色，流式細(xì)胞儀檢測產(chǎn)生Tγδ17細(xì)胞亞群（Vδ1、Vδ2及Vδ3-8亞群）比例及。3.采用密度梯度離心法分離外周血單個核細(xì)胞（PBMC），加入Mtb-Hag、HDMAPP和細(xì)胞因子（IL-1β、IL-23和TGF-β）培養(yǎng)3天后，加入rIL-2刺激培養(yǎng)9天后，使其成為富含效應(yīng)性γδ T細(xì)胞的細(xì)胞群，收集細(xì)胞用PMA/Ionomycin和Monensin刺激培養(yǎng)6小時，，用流式細(xì)胞儀檢測Tγδ17細(xì)胞亞群的比例。 結(jié)果： 1、TB患者60歲初治組（n＝16）γδ T細(xì)胞在T細(xì)胞中的比例（5.26%）低于正常人60歲組（n＝23）的比例（6.3%），TB患者60歲復(fù)治組（n＝16）γδ T細(xì)胞在T細(xì)胞中的絕對值（74.52%）低于TB患者60歲初治組60歲組（n＝34）的絕對值（144.69）（絕對值單位為101/μl）。 2、TB患者60歲初治組（n＝32）復(fù)治組（n＝16）的Vδ2+亞群在總γδ T細(xì)胞中比例（60.06%和48.82%）明顯低于正常人60歲組（n＝75）的比例（73.68%）（p均0.01）。TB患者60歲初治組（n＝32）復(fù)治組（n＝11）的Vδ1+亞群在總γδ T細(xì)胞中比例（25.01%和22.61%）明顯高于正常人60歲組（n＝75）的比例（11.82%）（p均0.05）。TB患者60歲復(fù)治組（n＝14）的Vδ3-8+亞群在總γδ T細(xì)胞中比例（33.17%）明顯高于正常人60歲組（n＝21）的比例（14.49%）（p0.05）。TB患者60歲初治組（n＝14）的Vδ1+亞群在總γδ T細(xì)胞中的絕對值（3.71）明顯低于TB患者60歲復(fù)治組（n＝10）的絕對值（11.71）。TB患者60歲初治組（n＝14）的Vδ3-8+亞群在總γδ T細(xì)胞中的絕對值（3.03）明顯低于TB患者60歲初治組（n＝32）的絕對值（14.89）（p均0.05.單位為101/μl）。 3、結(jié)核病組Tγδ17細(xì)胞中以Vδ3-8亞群最多，其次為Vδ2亞群，最少為Vδ1亞群。正常組Tγδ17細(xì)胞以Vδ3-8亞群最多，其次為Vδ1亞群，最少為Vδ2亞群。其中正常組γδ T細(xì)胞亞群:Vδ1亞群（n=14）、Vδ2亞群（n=18）和Vδ3-8亞群（n=14）的百分比分別為27.31%、10.52%和63.46%，而結(jié)核病組γδ T細(xì)胞亞群:Vδ1亞群（n=23）、Vδ2亞群（n=24）和Vδ3-8亞群（n=23）的百分比分別為5.03%、10.52%和75.03%。 4、從γδT細(xì)胞亞群的絕對值上進(jìn)行比較，正常組中產(chǎn)生Tγδ17細(xì)胞的亞群類別中Vδ1亞群與Vδ3-8亞群絕對值相當(dāng)，而結(jié)核病組產(chǎn)生Tγδ17細(xì)胞的亞群類別Vδ3-8亞群絕對值急劇升高。其中正常組γδ T細(xì)胞亞群:Vδ1亞群（n=14）、Vδ2亞群（n=18）和Vδ3-8亞群（n=14）的絕對值分別為2.46、0.19和2.78，而結(jié)核病組γδ T細(xì)胞亞群:Vδ1亞群（n=23）、Vδ2亞群（n=24）和Vδ3-8亞群（n=23）的絕對值分別為0.64、0.46和3.7。（單位為101/μl） 5、Mtb-Ag+CK組與HDMAPP+CK組在Tγδ17的比例比較中有明顯差異，前一組明顯比后組升高。Mtb-Ag+CK組與HDMAPP+CK組中Vδ2在Tγδ17所占比例比較中，前者較后者明顯降低。 結(jié)論： 1、在正常人中γδ T細(xì)胞主要以Vδ2+亞群為主，而在初治結(jié)核病、復(fù)治結(jié)核病以及矽肺患者中，Vδ2+亞群比例降低，而Vδ1+亞群比例增高或Vδ3-8+亞群比例增高。 2、TB患者60歲初治組復(fù)治組的Vδ2+亞群在總γδ T細(xì)胞中比例明顯低于正常人60歲組的比例。TB患者60歲初治組復(fù)治組的Vδ1+亞群在總γδ T細(xì)胞中比例明顯高于正常人60歲組的比例。TB患者60歲復(fù)治組的Vδ3-8+亞群在總γδ T細(xì)胞中比例明顯高于正常人60歲組的比例。 3、在正常人及TB患者，Tγδ17細(xì)胞中均以Vδ3-8亞群最多（60％以上）；正常人Tγδ17細(xì)胞中Vδ2亞群最少（半數(shù)人群檢測不到），而TB患者中的Tγδ17細(xì)胞中Vδ2亞群明顯升高；TB患者的Tγδ17細(xì)胞中Vδ1亞群明顯低于正常人。 4、正常人PBMC，用Mtb-HAg和磷酸抗原（HDMAPP）激活γδT細(xì)胞并同時加入含誘導(dǎo)性細(xì)胞因子（IL-1β、IL-23和TGF-β）培養(yǎng)（12天）后，均可誘導(dǎo)Tγδ17細(xì)胞的分化和增殖。前者誘導(dǎo)產(chǎn)生Tγδ17細(xì)胞的數(shù)量明顯多于后者。但在前者誘導(dǎo)的Tγδ17細(xì)胞中，Vδ2細(xì)胞數(shù)量明顯低于后者誘導(dǎo)的Tγδ17。
[Abstract]:BACKGROUND: The role of gamma delta T cells in host immunity against Mycobacterium tuberculosis (Mtb) infection has attracted more and more attention. Recent studies have reported that IL-17 secreting cells in mice infected with Mtb and BCG are mainly derived from gamma delta T cells. Recent studies in this laboratory have also found that the cells secreting IL-17 mainly come from gamma delta T cells outside the patients with active pulmonary tuberculosis (TB). The percentage of interleukin-17 (IL-17) producing gamma delta T cells (Tgamma delta 17 cells) in peripheral blood was significantly higher than that in normal controls. However, what subsets of T-gamma delta 17 cells belong to, and how the subtypes of T-gamma delta 17 cells in patients with pulmonary TB differ from those in healthy controls have not been reported. And transcription factors have been identified, but few studies have been done on the factors influencing the differentiation of T gamma delta 17 cells, such as cytokines, transcription factors and antigen regulation.
Objective: To investigate the subtypes of T gamma delta 17 cells (Vdel 1, Vdel 2 and Vdel 3-8) in peripheral blood of TB patients and healthy persons (HD) and to explore the differences between Tgamma delta 17 cells in TB patients and healthy persons, and the effects of thermostable antigen (M tb-HAg) of Mycobacterium tuberculosis (M.tb) and phosphorylated antigen (HDMAPP) on Tgamma delta 17 cells induced by cytokines. To explore the role of different lymphocyte subsets in the immune response to M.tb infection and the pathogenesis of TB.
Methods: 1. The peripheral blood samples of 70 active pulmonary tuberculosis patients, 100 HD patients and 33 silicosis patients were stained with fluorescent labeled monoclonal antibodies. The ratio of gamma delta T lymphocyte subsets (Vdel 1, Vdel 2 and Vdel 3-8) was detected by flow cytometry. 2. 24 active pulmonary tuberculosis patients and 17 HD patients were collected and the peripheral blood samples were added with phorbol alcohol ester (PMA) and phorbol alcohol ester (Vdel 3-8). Calcium ionomycin (Ionomycin) stimulated culture for 2 hours, then added monensin to culture for 4 hours. Cells were collected and labeled with fluorescent monoclonal antibodies for surface molecular and intracellular staining. Flow cytometry was used to detect the proportion of T gamma delta 17 cell subsets (Vdelta 1, Vdelta 2 and Vdelta 3-8) and. 3. Peripheral blood was isolated by density gradient centrifugation. Mononuclear cells (PBMC) were cultured with Mtb-Hag, HDMAPP and cytokines (IL-1 beta, IL-23 and TGF-beta) for 3 days, then stimulated with rIL-2 for 9 days. The collected cells were cultured with PMA/Ionomycin and Monosin for 6 hours. The ratio of T-gamma delta 17 subsets was detected by flow cytometry.
Result:
1. The percentage of gamma delta T cells in T cells in the 60-year-old newly treated group (n=16) was lower than that in the 60-year-old normal group (6.3%). The absolute value of gamma delta T cells (74.52%) in the 60-year-old retreated group (n=16) was lower than that in the 60-year-old newly treated group (n=34) of TB patients (144.69) (the absolute value unit was 101/ml).
2. The proportion of Vdelta 2+ subsets in total gamma delta T cells (60.06% and 48.82%) in the retreated group (n=16) of TB patients aged 60 years old was significantly lower than that in the normal group (73.68%) (p 0.01). The proportion of Vdelta 1+ subsets in total gamma delta T cells (25.01% and 22.61%) in the retreated group of TB patients aged 60 years old (n=32) was significantly higher than that in the normal group (n=11). The proportion of Vdelta 3-8 + subsets in total gamma delta T cells (33.17%) of TB patients aged 60 years after retreatment (n = 14) was significantly higher than that of normal people aged 60 years (n = 21) (14.49%) (p0.05). The absolute value of Vdelta 1 + subsets in total gamma delta T cells (3.71) of TB patients aged 60 years after retreatment was significantly lower than that of TB patients aged 60 years after retreatment (n = 14). The absolute value (11.71) of the treatment group (n = 10). The absolute value (3.03) of the Vdelta 3-8 + subsets in the total gamma delta T cells in the newly treated group (n = 14) of TB patients aged 60 was significantly lower than that in the newly treated group (n = 32) (14.89) (p 0.05.
3. The Vdelta 3-8 subset was the most common in Tgamma delta 17 cells of tuberculosis group, followed by Vdelta 2 subset and Vdelta 1 subset at least. The Vdelta 3-8 subset was the most common in Tgamma delta 17 cells of normal group, followed by Vdelta 1 subset and Vdelta 2 subset at least. The percentages of gamma delta T cell subsets in tuberculosis group were 5.03%, 10.52% and 75.03%, respectively.
4. Comparing the absolute values of the subtypes of T_ Delta T cells, the absolute values of V_ delta 1 and V_ delta 3-8 in the subtypes of T_ delta 17 cells in the normal group were the same, while the absolute values of V_ delta 3-8 in the subtypes of T_ delta 17 cells in the tuberculosis group increased sharply. The absolute values of the subgroup (n = 14) were 2.46, 0.19 and 2.78 respectively, while those of the gamma delta T cell subgroup (n = 23), V delta 2 (n = 24) and V delta 3-8 (n = 23) in the tuberculosis group were 0.64, 0.46 and 3.7, respectively.
5. The ratio of T gamma delta 17 in Mtb-Ag+CK group was significantly higher than that in HDMAPP+CK group. The ratio of V delta 2 in Mtb-Ag+CK group was significantly lower than that in HDMAPP+CK group.
Conclusion:
1. In normal subjects, Vdelta 2+ subsets were predominant in gamma delta T cells, while Vdelta 2+ subsets were decreased in patients with newly treated tuberculosis, retreated tuberculosis and silicosis, and Vdelta 1+ subsets were increased or Vdelta 3-8+ subsets were increased.
2. The proportion of Vdelta 2 + subsets in total gamma delta T cells in the retreated group of TB patients aged 60 was significantly lower than that in the normal group aged 60. The proportion of Vdelta 1 + subsets in total gamma delta T cells in the retreated group aged 60 was significantly higher than that in the normal group aged 60. The proportion of people aged 60 years old.
3. In normal and TB patients, the Vdelta 3-8 subset was the most common (more than 60%) in Tgam delta 17 cells, the Vdelta 2 subset was the least in normal Tgam delta 17 cells (not detected in half of the population), and the Vdelta 2 subset in Tgam delta 17 cells was significantly higher in TB patients than in normal subjects.
4. Normal PBMC, activated by Mtb-HAg and phosphoric acid antigen (HDMAPP) and cultured with inducible cytokines (IL-1 beta, IL-23 and TGF-beta) for 12 days, could induce the differentiation and proliferation of T gamma delta 17 cells. The number of T gamma delta 17 cells induced by the former was significantly higher than that by the latter. The amount of T gamma delta 17. is significantly lower than that of the latter.
【學(xué)位授予單位】：蚌埠醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R521

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