摘要
目的:研究CD44在肺结核患者体内的表达,并初步探讨其可能的作用机制。方法:选取本院拟诊为肺结核患者236例,分为肺结核组(n=152)和非肺结核组(n=84),随机选取健康体检者100名作为健康对照组,qRT-PCR检测不同组别人群外周血单个核细胞PBMC和结核性胸膜炎患者胸水中CD44的表达,ELISA检测治疗前后结核性胸膜炎患者血浆和胸水中CD44的水平;进一步分析CD44在结核感染中的产生机制和发挥作用的方式;同时分析CD44与T-spot. TB联合检测对肺结核的诊断价值。结果:在肺结核患者外周血PBMC和结核性胸膜炎患者胸水中CD44 mRNA的表达水平显著高于非肺结核组和健康对照组,肺结核患者血浆和结核性胸膜炎患者胸水中CD44蛋白浓度显著高于非肺结核组和健康对照组;治疗后3、6、9月肺结核患者的外周血中CD44的mRNA水平,以及血浆中CD44浓度,显著降低,相比治疗前差异具有统计学意义;CD44和结核杆菌共作用的THP-1细胞可以显著提高细胞中CCL-2的表达,表明CD44通过促进结核杆菌感染的巨噬细胞中CCL2的表达来调节细胞的迁移;利用TNF-α中和抗体或者功能性TNF-α作用THP-1细胞,结果发现TNF-α可以显著提高细胞中CD44的表达。结论:CD44在结核患者体内高表达,可能是由于结核患者中高表达的TNF-α,从而刺激巨噬细胞产生CD44,为肺结核的临床诊断提供一定的研究基础。
Objective:To study the expression of CD44 in pulmonary tuberculosis patients and explore the possible mechanisms.Methods:236 patients suspected with pulmonary tuberculosis were selected and divided into pulmonary tuberculosis group(n=152)and non-pulmonary tuberculosis group(n=84),and 100 healthy people were randomly selected as healthy control group.The expression of CD44 was evaluated by qRT-PCR and ELISA in peripheral blood and pleural effusion from different patients.The CD44 levels at pre and post-treatment time points were determined by ELISA.The inducing factors of increased CD44 and the potentialroles played by CD44 in the pathogenesis of TB were also evaluated.We elucidated whether CD44 detection could combine with T-spot.TB to diagnose pulmonary tuberculosis rapidly and accurately.Results:The expression of CD44 in pulmonary tuberculosis patients was higher compared with the non-pulmonary tuberculosis patients and healthy people,and would be down-regulated after treatment for 3,6 and 9 months.Besides,CD44 could not remove H37Ra by the CFU assay,and could promote the expression of CCL-2,indicating that CCD4 promote the mobility the THP-1 via induction of CCL-2.Besides,TNF-αneutralizing antibody,added into the macrophages,could inhibit the expression of CD44,and functional TNF-αinduced the expression of TNF-α.Conclusion:CD44 is highly expressed in pulmonary tuberculosis patients,which may be due to the high expression of TNF-αin pulmonary tuberculosis patients,stimulating macrophages to produce CD44,and it will provide a basis for clinical diagnosis of pulmonary tuberculosis.
作者
张宪波
刘月皎
钱世宁
董杰
ZHANG Xian-Bo;LIU Yue-Jiao;QIAN Shi-Ning;DONG Jie(Clinical Laboratory of Jiangsu Province Hospital of TCM,Nanjing 210029,China)
出处
《中国免疫学杂志》
CAS
CSCD
北大核心
2019年第2期213-219,共7页
Chinese Journal of Immunology
