The Study Of The Effect Of Cytokine-induced Killer On Multi-drug Resistance Tuberculosis Based On Analysis Of The Characteristics Of T Subsets And The Clinical Significance

Part 1:Characteristics and clinical significance of peripheral blood lymphocyte subsets from new and retreatment cases of pulmonary tuberculosisObjective:This study aims to investigate the changes and clinical significance of the frequencies of peripheral blood T-cell subsets from new and retreatment cases of tuberculosis.Methods:The frequencies of peripheral blood T lymphocyte subsets were determined by using flow cytometry and then the correlation with clinical parameters was analyzed.Results:The results showed that in the peripheral blood of new cases of pulmonary tuberculosis,the frequencies of B lymphocytes and CD4~+CD28~+population were both significantly increased while the frequency of NK cells decreased significantly compared with the control group.However,no significant difference between the new cases and the control groups for the frequencies of T lymphocytes,CD4~+T lymphocytes,CD8~+T lymphocytes,CD8~+CD28~+,CD8~+CD28~-,CD4~+CD28~-populations,and the ratio of CD4 to CD8.Intriguingly,in the peripheral blood of the retreatment cases,the frequencies of CD4~+CD28~+,CD4~+CD28~-and CD8~+CD28~-populations were significantly higher than that in the control group.However,there was no significant difference for B lymphocytes,T lymphocytes,NK cells,CD4~+T lymphocytes,CD8~+T lymphocytes,and the ratio of CD4 and CD8.Moreover,we found that the frequencies of CD4~+CD28~+and CD8~+CD28~+in the peripheral blood of the retreatment cases were significantly lower than those with the new cases while the frequencies of CD4~+CD28~-and CD8~+CD28~-were significantly higher.Additionally,we found that in new cases,the frequency of T lymphocytes from the pulmonary tuberculosis patients with cavity were significantly increased compared with the patients without cavity,while the frequency of NK cells decreased obviously.Conclusion:In conclusion,varying degrees of abnormalities of the lymphocyte subsets from new cases and retreatment cases of pulmonary tuberculosis were observed and might provide some valuable index for diagonsis of pulmonary tuberculosis.Part 2:Analysis of the correlation between TB-IGRA and T cell subgroup and disease condition of TB patientsObjective:TB-IGRA test has the characteristics of short time,high specificity,and high sensitivity,but it lacks the correlation research between TB-IGRA test results and body's immune cells,disease progression and prognosis,which is explored in this study.Methods:The frequencies of peripheral blood lymphocyte subsets were determined by using flow cytometry.The TB-IGRA,routine blood test,T cell subgroup data were collected for statistical analysis.Results:TB-IGRA results were in positive proportion to the lymphocytes,CD4~+T cells and CD4~+CD28~+T cells,while negative to the Treg cells.Patient with unilateral pulmonary lesion had higher TB-IGRA than bilateral pulmonary lesions.IFN-?was tested with TB-IGRA in TB patients by the specific tuberculosis T cells and correlated with the lymphocytes,while the lymphocytes also closely related to the host's anti-tuberculosis immunity and disease outcome.So the result of TB-IGRA could reflect the host's specific anti-tuberculosis immunity ability,disease progression and prognosis.Conclusion:The study further expands the application scope of TB-IGRA technology in the diagnosis of tuberculosis and lays a foundation for clinical to understand the immune state of TB patients and the application of auxiliary clinical immunity regulators.Part 3:Preliminary research of the effect of CIK in combination with antibiotics on patients severely infected with multi-drug resistanceMycobacterium tuberculosisObjective:This study aims to study the therapeutic effects of CIK in combination with antibiotics on patients severely infected with multi-drug resistant Mycobacterium tuberculosis.Methods:PBMCs fromtuberculosispatientswereculturedwith CIK-inducingmedium and then were reinfusated into patients in combination with antibiotics for treatment.Treatment only with antibiotics was designed as the control.During the treatment of month 0,1,3,clinical symptoms,and indexes of serology and immunology were monitored,and then do statistical comparison analysis between the 2groups.Results:Compared with the control group,cough,expectoration,sputum smearand mycobacterium tuberculosis sputum culture from patients received CIK treatment are all obviously relieved after 1 month and 3 months.After 3 months,the improvement of pulmonary lesions in CIK treated group is better than control group.Conclusion:CIK in combination with antibioticshas a potential therapeutic value in treating patients severely infected with multi-drug resistant Mycobacterium tuberculosis.