Objective Dynamic monitoring of T-bet, GATA-3, RORγt and Foxp3 immunomodulatory cell-specific gene mRNA abundance in peripheral blood of patients with tuberculosis (TB) were conducted during treatment to explore the immunomodulatory trends and effects of tuberculosis lesions.
Methods Totally 52 confirmed TB patients were selected as treatment group and 50 healthy patients as control group. Real-time quantitative PCR was used to determine the expression of the above gene as well as the IFN- γ, IL-4, IL-17, IL-10 transcription factors at the 0 month, 3 months and 6 months of the treatment period. The ratio changes of immunomodulatory balance Th1/Th2 and Th17/Treg in patients and healthy populations were dynamically observed.
Results In the first visit group， T-bet mRNA expression and RORγt/Foxp3 ratio were lower than the control group( P<0.05), the expression of RORγt and Foxp3 mRNA were higher than those in the control group( P<0.05); In the first visit group and the 3 months treatment group, the GATA-3 mRNA expression were higher than that in the control group ( P<0.05), and the T-bet/GATA-3 ratios were lower than that in the control group ( P<0.05). The T-bet mRNA expression and the T-bet / GATA-3 ratio of the 6 months treatment group were significantly higher than the first visit group and the 3 months treatment group( P<0.05); In the 3 months and 6 months treatment groups, the mRNA expression of RORγt and Foxp3 were lower than those in the first visit group( P<0.05). In the first visit group and treatment group, the mRNA expression of IFN- γ was lower than that in the control group( P<0.05), the mRNA expression of IL-4, IL-17 and IL-10 were higher than those in the control group( P<0.05).
Conclusion TB patients have Th1 / Th2 imbalance of transcription factor level, showing Th2 drift phenomenon. Th17 cells and Treg cells may play an important pro-inflammatory and immunosuppressive roles in the development of TB. Anti-tuberculosis treatment can improve their abnormal expression.
摘要： 目的 动态监测治疗期肺结核(tuberculosis, TB)患者外周血中 T-bet、 GATA-3、 RORγt 和 Foxp3 等免疫调节细 胞特异性基因 mRNA 丰度变化，探索结核病变过程中机体的免疫调节趋势及作用。 方法 选择 52 例确诊肺结核患者 为病例组，50 名体检健康者作为对照组。通过实时定量 PCR 方法测定上述基因以及 IFN-γ、IL-4、IL-17、IL-10 等细胞 因子特异性基因在治疗期第 0 个月、3 个月、6 个月的表达水平，动态观察患者及健康人群体内免疫调节平衡 Th1/Th2 和 Th17/Treg 变化。 结果 初诊组 T-bet mRNA 表达、 RORγt / Foxp3 分别低于正常对照组( P<0.05)， RORγt 和 Foxp3 mRNA 表 达分别高于正常对照组( P<0.05)；初诊组和治疗 3 月组 GATA-3 mRNA 的表达均高于正常对照组( P<0.05)， T-bet/GATA-3 均低于正常对照组( P<0.05)。治疗 6 月组 T-bet mRNA、 T-bet/GATA-3 分别高于初诊组和治疗 3 月组( P<0.05)；治疗 3 月组 和治疗 6 月组 RORγt、 Foxp3 mRNA 均分别低于初诊组( P<0.05)。初诊组和治疗组 IFN-γ mRNA 均低于对照组， IL-4、IL-17、IL-10 的 mRNA 均高于对照组( P<0.05)。 结论 肺结核患者存在转录因子水平 Th1/Th2 失衡，呈现 Th2 漂移现象。 Th17 细胞和 Treg 细胞可能在 TB 的发生过程中起着重要的促炎作用和免疫抑制作用。抗结核治疗能够改善上述转录 因子的异常表达。