The Expression Level And Significance Of CD4~+CD28~-T Lymphocytes And Cytokines In Pleural Effusion And Peripheral Blood Of Patients With Tuberculous Pleurisy

Objective The research aimed to investigate the expression and significance of CD4~+CD28~-T lymphocytes,monocyte chemotactic protein-1(MCP-1)and transforming growth factor-β1(TGF-β1)in pleural effusion and peripheral blood from patients with tuberculous pleurisy.Methods1.The expression level and significance of CD4~+CD28~-T lymphocytes in pleural effusion and peripheral blood of patients with tuberculous pleurisy Pleural effusion and peripheral blood samples were collected from 40 patients with pleural effusion who were untreated in the First Affiliated Hospital of Guangxi Medical University from March 2015 to December 2016,including20 cases of tuberculous pleurisy patients,20 cases of non tuberculous patients,in addition,18 cases of healthy people in medical examination center of the First Affiliated Hospital of Guangxi Medical University were served as control group.Pleural effusion were collected in 40 patients with pleural effusion by thoracentesis,all peripheral blood samples were collected by vacuum blood collecting.The percentage of CD4~+CD28~-T lymphocytes was assayed by flow cytometry.Comparing the percentage of CD4~+CD28~-T lymphocytes in pleural effusion of tuberculous pleurisy group and non tuberculous pleurisy group;comparing the percentage of CD4~+CD28~-T lymphocytes in peripheral blood of three groups;meanwhile,correlation analysis of the percentage of CD4~+CD28~-T lymphocytes in pleural effusion and peripheral blood for each group.2.The expression level and significance of MCP-1 and TGF-β1 in pleural effusion Pleural effusion and peripheral blood samples were collected from 146 patients with pleural effusion who were untreated in the First Affiliated Hospital of Guangxi Medical University from January 2009 to December 2016,included59 cases of tuberculous pleurisy patients,54 cases of malignant pleural effusion patients,18 cases of transudative pleural effusion patients and 15 patients with empyema.Pleural effusions were collected by thoracentesis,peripheral blood samples were collected by vacuum blood collecting.Double antibody sandwich enzyme-linked immunosorbent assay(ELISA)was used to detect the concentrations of MCP-1 and TGF-β1 in pleural effusions and the corresponding serum,comparing the concentrations of MCP-1 and TGF-β1 in pleural effusion and peripheral blood for each group,draw the receiver-operating-characteristic(ROC)curves,then analyze the clinical diagnostic significance of MCP-1 and TGF-β1.3.Correlation analysis of the concentrations of MCP-1 and TGF-β1 with the percentage of CD4~+CD28~-T lymphocytes.4.Comparisons of the data between different groups were performed usingone-way analysis of variance(ANOVA);comparisons of the data between two groups were performed using t-test;the correlations between variables were determined by Spearman rank correlation coefficients;analysis of diagnostic value by ROC curves.Results1.The expression level and significance of CD4~+CD28~-T lymphocytes in pleural effusion and peripheral blood of patients with tuberculous pleurisy1)The percentage of CD4~+CD28~-T lymphocytes in pleural effusion was significantly higher in tuberculous pleurisy group compared with non tuberculous pleurisy group [(14.69±4.1)% vs.(9.75 ±3.4)%,P<0.05].2)The percentage of CD4~+CD28~-T lymphocytes in peripheral blood was higher in tuberculous pleurisy group compared with non tuberculous pleurisy group and healthy control group [(5.26±2.9)% vs.(3.76±2.1)%,P < 0.05);(5.26±2.9)% vs.(3.29 ±1.8)%,P<0.05].3)Tuberculous pleurisy group,the percentage of CD4~+CD28~-T lymphocytes in pleural effusion was positively correlated with peripheral blood(r=0.543,P<0.05).2.The expression level and significance of MCP-1 and TGF-β1 in pleural effusion1)In pleural effusion,the concentrations of MCP-1 and TGF-β1 in tuberculous pleurisy group were higher compared with malignant group,transudative group and empyema group(P<0.05).2)In serum,the concentrations of TGF-β1 in tuberculous pleurisy group were higher compared with malignant group,transudative group and empyema group(P<0.05).But the concentrations of MCP-1 were no significant differencebetween four groups(P>0.05).3)Compared with pleural effusion and corresponding serum in the four groups,the concentrations of MCP-1 in pleural effusion were higher compared with corresponding serum(P < 0.05);the concentrations of TGF-β1 in serum were higher compared with corresponding pleural effusion(P<0.05).4)The diagnostic value of the concentrations of MCP-1 for tuberculous pleural effusion was 1090.91 pg/m L,the area under ROC curve was 70.5 %,the sensitivity was 84.7 %,the specificity was 78.8 %;the diagnostic value of the concentrations of TGF-β1 for tuberculous pleural effusion was 2412.78 pg/m L,the area under ROC curve was 80.0 %,the sensitivity was 86.2 %,the specificity was 81.2 %;the diagnostic value of the concentrations of MCP-1 and TGF-β1 for tuberculous pleural effusion was 1520.58 pg/m L,the area under ROC curve was 79.3 %,the sensitivity was 89.3 %,the specificity was 80.6 %。3.In tuberculous pleural effusion,the percentage of CD4~+CD28~-T lymphocytes in pleural effusion was positively correlated with the concentrations of MCP-1、TGF-β1(r=0.601,0.582,P<0.05).Conclusions1.The change of the proportion of CD4~+CD28~-T lymphocytes may affects the development of tuberculous pleurisy,and may play an important role in immunoregulation of tuberculous pleurisy.2.The detection of the concentrations of MCP-1 and TGF-β1 in pleural effusion has important value in clinical diagnosis of tuberculous pleural effusion,malignant pleural effusion,transudative pleural effusion and purulent exudates.3.MCP-1 and TGF-β1 may be involved in the regulation of CD4~+CD28~-T lymphocytes and inflammatory reaction in tuberculous pleurisy.