摘要
目的探讨外周血细胞毒性T淋巴细胞相关抗原-4(CTLA-4)、可溶性CD14(sCD14)和膜结合性CD14(mCD14)在布鲁氏菌病患者中表达水平及其相关性。方法选取2019-06-01-2021-06-01郑州市第六人民医院收治的116例布鲁氏菌患者为研究对象,其中急性布鲁氏菌患者63例(急性布鲁病组),慢性布鲁氏菌患者53例(慢性布鲁病组)。选取同期同院116例体检健康者为对照组。酶联免疫吸附法检测血清中CTLA-4、sCD14、肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-6、IL-2水平,采用流式细胞术检测外周血单个细胞核mCD14表达水平。采用Pearson法分析血清CTLA-4、sCD14水平与TNF-α、IL-6、IL-2的相关性。多因素Logistic回归分析布鲁氏菌病的影响因素。结果与对照组sCD14[(943.47±124.28)ng/mL]、CTLA-4[(41.27±8.17)pg/mL]、mCD14[(7.25±1.63)%]相比,慢性布鲁病组外周血血清sCD14水平[(1568.17±309.52)ng/mL]、CTLA-4水平[(76.28±14.39)pg/mL]、外周血单个核细胞中mCD14[(11.72±3.08)%]表达较高,均P<0.05;与慢性布鲁病组相比,急性布鲁病组血清sCD14水平[(2075.48±325.16)ng/mL]、CTLA-4水平[(126.73±28.44)pg/mL]、外周血单个核细胞中mCD14[(27.49±6.05)%]表达较高,均P<0.05。与慢性布鲁病组TNF-α[(22.94±5.02)pg/mL]、IL-6[(23.84±5.61)pg/mL]、IL-2[(2.94±0.62)pg/mL]相比,急性布鲁病组血清TNF-α水平[(30.28±5.86)pg/mL,t=7.169,P<0.001]、IL-6水平[(58.73±6.68)pg/mL,t=30.120,P<0.001]较高,血清IL-2水平[(2.32±0.51)pg/mL,t=5.912,P<0.001]降低。Pearson法分析结果显示,CTLA-4、sCD14与TNF-α、IL-6呈正相关(P<0.001),与IL-2呈负相关(P<0.001)。Logistic回归分析结果显示,CTLA-4(OR=1.941,95%CI为1.251~3.011,P=0.004)、TNF-α(OR=1.914,95%CI为1.053~3.479,P=0.033)、IL-6(OR=2.111,95%CI为1.152~3.868,P=0.015)、sCD14(OR=2.229,95%CI为1.454~3.417,P<0.001)是布鲁氏菌病的独立危险因素,IL-2(OR=0.502,95%CI为0.315~0.799,P=0.004)是布鲁氏菌病的保护因素。结论外周血CD14及血清CTLA-4在布鲁氏菌病患者中高表达,CTLA-4、CD14共同参与布鲁氏菌对宿主的免疫调控作用。
Objective To explore the expression levels and correlation analysis of peripheral blood cytotoxic T lymphocyte-associated antigen-4(CTLA-4),soluble CD14(sCD14)and membrane-bound CD14(mCD14)in patients with brucellosis.Methods A total of 116 patients with Brucella admitted to Zhengzhou Sixth People’s Hospital from June 1,2019 to June 1,2021 were selected as the research subjects,including 63 patients with acute Brucella(acute Brucella group)and 53 patients with chronic Brucella(chronic Brucellosis group),another 116 healthy people with physical examination in our hospital were selected as the control group during the same period.Enzyme-linked immunosorbent assay was used to detect serum levels of CTLA-4,sCD14,tumor necrosis factor-α(TNF-α),interleukin(IL)-6 and IL-2,flow cytometry was used to detect the expression level of mCD14 in peripheral blood mononuclear cells.Pearson method was used to analyze the correlation between serum CTLA-4,sCD14 levels and TNF-α,IL-6 and IL-2.Multivariate Logistic regression was used to analyze the factors affecting brucellosis.Results Compared with sCD14[(943.47±124.28)ng/ml],CTLA-4[(41.27±8.17)pg/ml],mCD14[(7.25±1.63)%]in the control group,the sCD14level[(1568.17±309.52)ng/ml],CTLA-4level[(76.28±14.39)pg/ml]in peripheral blood serum,and mCD14expression in peripheral blood mononuclear cells[(11.72±3.08)%]were higher in the chronic brucellosis group(P<0.05);compared with the chronic brucellosis group,the serum sCD14level[(2075.48±325.16)ng/ml],CTLA-4level[(126.73±28.44)pg/ml]and mCD14expression in peripheral blood mononuclear cells[(27.49±6.05)%]were higher in the acute brucellosis group(P<0.05).Compared with the chronic brucellosis group TNF-α[(22.94±5.02)pg/ml],IL-6[(23.84±5.61)pg/ml],IL-2[(2.94±0.62)pg/ml],the serum TNF-αlevel[(30.28±5.86)pg/ml](t=7.169,P<0.001),IL-6level[(58.73±6.68)pg/ml](t=30.120,P<0.001)were higher in the acute brucellosis group,the IL-2level[(2.32±0.51)pg/ml](t=5.912,P<0.001)was lower.Pearson analysis showed that CTLA-4and sCD14 were positively correlated with TNF-αand IL-6(P<0.05),and negatively correlated with IL-2(P<0.05).Logistic regression analysis showed that CTLA-4(OR=1.941,95%CI:1.251-3.011,P=0.004),TNF-α(OR=1.914,95%CI:1.053-3.479,P=0.033),IL-6(OR=2.111,95%CI:1.152-3.868,P=0.015)and sCD14(OR=2.229,95%CI:1.454-3.417,P<0.001)were independent risk factors for brucellosis,and IL-2(OR=0.502,95%CI:0.315-0.799,P=0.004)was a protective factor for brucellosis.Conclusions Peripheral blood CD14and serum CTLA-4are highly expressed in patients with brucellosis.CTLA-4and CD14participate in the immune regulation of Brucella to the host.
作者
李欣容
卢伟霞
王秀云
LI Xin-rong;LU Wei-xia;WANG Xiu-yun(Department of Endemic Disease Prevention and Control,Zhengzhou Center for Disease Control and Prevention,Zhengzhou 450007,China;Third Department of Infection,Zhengzhou Sixth People's Hospital,Zhengzhou 450015,China)
出处
《社区医学杂志》
CAS
2022年第11期641-646,共6页
Journal Of Community Medicine
作者简介
通信作者:李欣容,女,河南长垣人,主管技师,主要从事临床微生物检验的研究工作。E-mail:ooliew78@163.com
