新生隐球菌性脑膜炎患者外周血Th1/Th2及相关T淋巴细胞水平变化及意义

摘要/Abstract

摘要：

目的通过检测新生隐球菌性脑膜炎患者外周血中Th1及Th2 类细胞及NKT细胞、T细胞的分布比例，从患者水平进一步了解机体T辅助淋巴细胞及相关T淋巴细胞在新生隐球菌感染过程中的作用机制。方法收集新生隐球菌性脑膜炎/脑膜脑炎的16例患者（HIV检测阴性）及作为对照组的10例正常健康人外周血标本，采用流式细胞技术检测标本中Th1及Th2类细胞及NKT细胞、γδT细胞的在外周血T淋巴细胞中的分布比例，并采用SPSS 11.0软件进行统计分析比较。结果隐脑患者（接受诱导治疗前）Th1细胞在CD4+T淋巴细胞中所占比例为（13.093±4.618）%，低于正常对照组的比例（19.582±4.949）%，而Th2细胞所占比例为（1.769±0.865）%，高于正常对照组的比例（0.584±0.202）%，差异皆有统计学意义（P<0.01）；隐脑患者经诱导治疗好转后Th1细胞在CD4+T淋巴细胞中所占比例为（16.069±1.516）%，较好转前的比例（13.589±2.101）%增加，Th2细胞所占比例为（1.499±0.274）%，较好转前的比例（1.673±0.290）%下降，但差异皆无统计学意义（P>0.05）；隐脑患者（接受诱导治疗前）NKT细胞在整体T淋巴细胞中所占比例为（11.848±2.936）%，低于正常对照组的比例（17.918±8.088）%，差异有统计学意义（P<0.05），而隐脑患者的γδT细胞在整体T淋巴细胞中所占比例为（9.166±3.989）%，与正常对照组的比例（9.873±3.509）%对比差异无统计学意义（P>0.05）；隐脑患者经治疗好转后NKT细胞在T淋巴细胞中所占比例为（14.806±1.513）%，较好转前比例（11.830±1.350）%增加，γδT细胞所占比例为（6.984±0.843）%，则较好转前比例（8.094±2.037）%下降，但差异皆无统计学意义（P>0.05）。结论新生隐球菌性脑膜炎患者存在Th1细胞减少，Th2细胞增加，及NKT细胞在T淋巴细胞中所占比例下降，其说明新生隐球菌性脑膜炎患者的细胞免疫功能明显低下；经治疗好转后的病例，Th1/Th2失衡状态改善，可能提示患者的细胞免疫功能恢复对疾病预后起重要作用。

关键词: 新生隐球菌, 感染, Th1/Th2, NKT, γδT

Abstract:

Objective This study is to further understanding the mechanism of T helper cells in course of C.neofermans infection from patient's level through measuring the proportions of Th1/Th2 cell factors and NKT cells,γδT cells in peripheral blood between normal adult and patients.Analyze whether the change presents relevance with the disease prognosis.Method The peripheral blood samples were collected from 16 patients with cryptococcal meningitis,and 10 healthy people.The proportions of Th1/Th2 cell factors and NKT cells,γδ T cells were analyzed by flow cytometry (FCM).Results 1.The proportion of Th1 cells in CD4 +T lymphocyte of patients with cryptococcal meningitis before treatment was (13.093±4.618)%,less than that of healthy people (19.582±4.949)%,P<0.01.And the proportion of Th2 cells was (1.769±0.865)%,higher than that of healthy people (0.584±0.202)%,P<0.01.2.Patients who received treatment showed the increased levels of Th1 cells in CD4 +T lymphocyte (16.069±1.516)% which was higher than those in patients before treatment (13.589±2.101)%,P>0.05.The proportion of Th2 cells in the patients had received treatment was (1.499±0.274)%,less than those of patients before treatment (1.673±0.290)%,P>0.05.3.The proportion of NKT cells in T lymphocyte of patients with cryptococcal meningitis before treatment was (11.848±2.936)%,less than those of healthy people (17.918±8.088)%,P<0.05.No significant differences of proportions of γδT in T lymphocyte among patients before treatment and healthy people,P>0.05.4.Patients who received treatment showed the increased levels of NKT cells in T lymphocyte (14.806±1.513)% which was higher than those in patients before treatment (11.830±1.350)%,P>0.05.The proportion of γδT cells in the patients who had received treatment was (6.984±0.843)%,less than those of patients before treatment (8.094±2.037)%,P>0.05.Conclutions 1.The balance of Th1/Th2 falls towards Th2 and the decrease of the proportion of NKT cells among T lymphocytes in patients with cryptococcal meningitis.It suggests that the cell-mediated immunity of patients with cryptococcal meningitis is weakened.2.Once the patients get better after treatment,Th1/Th2 imbalance would be corrected in that the balance turned to Th1 direction.It suggests that the recovery of cell-mediated immunity may improve the prognosis of these disease.

Key words: Cryptococus neofermans, infections, Th1/Th2, NKT, γδT

中图分类号:

R519.4

黄煌, 冼莹, 潘越峻, 张扣兴. 新生隐球菌性脑膜炎患者外周血Th1/Th2及相关T淋巴细胞水平变化及意义[J]. 中国真菌学杂志, 2017, 12(5): 268-273,267.

HUANG Huang, XIAN Ying, PAN Yue-jun, ZHANG Kou-xing. The proportions of Th1/Th2 and Relevant T lymphocytes in patients with cryptococcal meningitis and its clinical significance[J]. Chinese Journal of Mycology, 2017, 12(5): 268-273,267.

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