Expression And Clinical Significance Of TGF-β1、MMP-9 And TIMP-1 In Endobronchial Tuberculosis

Objective:Understand that transforming growth factor-β1(TGF-β1),matrix metalloproteinase-9(MMP-9),and its inhibitor,matrix metalloproteinase-1(TIMP-1),in newly diagnosed tuberculosis with bronchial tuberculosis and early Treatment of pulmonary tuberculosis without bronchial tuberculosis in patients before and after treatment of anti-tuberculosis expression levels and their relationship,analysis of its classification with bronchial tuberculosis,treatment of fibrous bronchial stenosis after the relationship between and further explore the three cytokines in the bronchial tuberculosis Possible mechanisms of action in the formation of stenotic cavities.Methods :Thirty patients with initially treated pulmonary tuberculosis without bronchial tuberculosis were observed in group A.30 patients with newly diagnosed pulmonary tuberculosis and bronchial tuberculosis were observed in group B,and 30 healthy people were included in the control group.ELISA was used to detect the levels of serum TGF-β1,MMP-9,and TIMP-1 in healthy controls before and after antituberculous treatment in group B and after observation of antituberculous treatment in group B.ELISA method was used to observe the levels of TGF-β1,MMP-9 and TIMP-1 in the bronchoalveolar lavage fluid before and after the observation of antituberculous treatment in group B and B group.The relationship between the level of TGF-β1,MMP-9 and TIMP-1 in patients with bronchial tuberculosis and their relationship with bronchial tuberculosis classification and prognosis,then to explore the relationship between local cellular immune function and the evolution of bronchial tuberculosis in patients with bronchial tuberculosis.Results :1.The levels of serum TGF-β1 in tuberculosis without tuberculosis were higher than those in healthy control group(p<0.05).There was no significant difference in serum TGF-β1 between tuberculosis tuberculosis and control group(p> 0.05);pulmonary tuberculosis without bronchial tuberculosis group serum TGF-β1 levels were higher than the pulmonary tuberculosis with bronchial tuberculosis group,the difference was statistically significant(p <0.05).Subgroup analysis showed that serum TGF-β1 levels were lower in patients with bronchofibrosis after treatment than in those without stenosis,and serum TGF-β1levels were significantly lower than those in the initial serum after 6 months of treatment(p<0.01).2.The level of TGF-β1 in bronchoalveolar lavage fluid in pulmonarytuberculosis with bronchial tuberculosis was higher than that in tuberculosis without tuberculosis,and the levels of TGF-β1 in bronchoalveolar lavage fluid rechecked after 6 months of treatment were higher than those before treatment.Subgroup analysis The TGF-β1 levels in the bronchoalveolar lavage fluid before and after treatment were significantly higher than those without stenosis,and the TGF-β1 levels in the bronchoalveolar lavage fluid after treatment were also higher than those in the bronchial fiber stenosis group,Significantly higher than before.3.Serum levels of MMP-9,TIMP-1,MMP-9/TIMP-1: The levels of serum MMP-9 and TIMP-1 before tuberculosis in the patients without pulmonary tuberculosis and tuberculosis in the tuberculosis group were significantly higher than those in the control group.There was statistical significance(p<0.05),and there was no significant difference in the levels of MMP-9/TIMP-1 between the three groups(p>0.05).There was no significant difference in serum MMP-9 levels before and after treatment in patients with pulmonary tuberculosis and bronchial tuberculosis(p>0.05);TIMP-1 levels in patients with pulmonary tuberculosis and bronchial tuberculosis after treatment were higher than before treatment,and the difference was statistically significant(p< 0.05);Pulmonary tuberculosis with bronchial tuberculosis group after treatment MMP-9/TIMP-1 levels decreased compared with before treatment,the difference was statistically significant(p<0.05).4.Levels of MMP-9,TIMP-1,and MMP-9/TIMP-1 in bronchoalveolar lavage fluid: The levels of MMP-9 in bronchial lavage fluid before and after treatment in patients with pulmonary tuberculosis and bronchial tuberculosis were significantly higher than those in patients without bronchial tuberculosis.The difference was statistically significant(p<0.01).There was no significant difference in MMP-9 levels between bronchial lavage fluid before and after treatment in patients with pulmonary tuberculosis and bronchial tuberculosis(p>0.05).The levels of TIMP-1 in tracheal lavage fluid before and aftertuberculosis in the tuberculosis tuberculosis group were higher than those in the tuberculosis tuberculosis group without tuberculosis(p<0.05).The tuberculosis in the tuberculosis tuberculosis group before and after treatment The level of TIMP-1in lavage fluid was statistically significant(p<0.05).The levels of MMP-9/TIMP-1in the bronchoalveolar lavage fluid before treatment were lower than those in the tuberculosis without bronchial tuberculosis(P<0.05).The level of MMP-9/TIMP-1was significantly lower than that of pulmonary tuberculosis without bronchial tuberculosis(p<0.01).The levels of MMP-9/TIMP-1 in the bronchoalveolar lavage fluid before and after treatment in patients with pulmonary tuberculosis and bronchial tuberculosis were significantly reduced.The difference was statistically significant(p<0.05).Conclusion:1.The high expression of MMP-9 and TIMP-1 in bronchial lavage fluid was found in pulmonary tuberculosis with and without bronchial tuberculosis,suggesting that MMP-9 and TIMP-1 might be related to airway injury and fibrosis stenosis of bronchial tuberculosis.The high expression of MMP-9 and TIMP-1 in broncho-lavage fluid before treatment and the increase of the ratio of MMP-9 / TIMP-1 in TIMP-1 after treatment suggested that the imbalance of MMP-9 / TIMP-1 ratio might be related to bronchial fibrous stenosis.2.TGF-β1 in broncholavage fluid of pulmonary tuberculosis with bronchial tuberculosis group was higher than that in control group before treatment,but there was no significant difference in serum.The level of TGF-β1 in bronchial lavage fluid was higher in the group with bronchial fiber stenosis than that in the group without bronchofibrostenosis before treatment,suggesting that TGF-β1 may play an important role in local immunity.3.The changes of TGF-β1,MMP-9,TIMP-1and MMP-9 / TIMP-1 in bronchial lavage fluid were more consistent with the clinical outcome of bronchial tuberculosis,suggesting that bronchial lavage fluid could reflect airway injury and repair better than serum.The combined examination of TGF-β1,MMP-9 and TIMP-1 in bronchial lavage fluid is valuable in predicting the prognosis ofbronchial fibrous stenosis after treatment of bronchial.