Clinical Significances Of The Lymphocyte Activation Markers And Cytokines In Differentiating Active And Latent Tuberculosis Infection With Healthy People

Objective:To evaluate the clinical significances of lymphocytes subsets,lymphocyte activation markers and extracellular cytokines in differentiating the active and latent tuberculosis infected(ATBI,LTBI)patients from the healthy controls(HCs).Methods:41 ATBI patients,24 LTBI patients and 30 HCs peripheral anticoagulant blood samples were collected.Flow cytometry was applied to detect the percentage of lymphocyte subsets,lymphocyte activation markers and cytometric beads array was used to detect the concentration of extracellular cytokines of participants.Logistic regression and receiver operating characteristic(ROC)curve analysis were used to evaluate the performances of each parameter in diagnosis and differential diagnosis of active and latent pulmonary tuberculosis.Results:As compared with the LTBI patients,ATBI patients had significantly higher levels of regulatory T cells(Treg cells)(7.75±2.24%vs 6.15±1.47%,P<0.01)and IFN-?(2.65±0.80 pg/ml vs 2.06±0.31 pg/ml,P<0.01).As compared with the HCs,the ATBI and LTBI patients had significantly higher levels of the CD3~+HLA-DR~+cells(5.34±7.64%and 4.10±3.39%vs 1.74±0.73%respectively,P<0.01),CD4~+HLA-DR~+cells(2.18±2.47%and 1.47±0.91%vs 0.68±0.36%respectively,P<0.01),CD8~+HLA-DR~+cells(2.66±5.11%and 2.12±2.06%vs 0.88±0.44%respectively,P<0.05),IL-6(3.25±2.94 pg/ml and 5.05±6.20 pg/ml vs 1.78±0.97pg/ml respectively,P<0.01)and lower levels of the CD8~+CD28~+cells,NK cells.Unlike LTBI patients,the levels of CD4~+/CD8~+T cells,Treg cells,CD16~+CD56~+CD69~+cells,IFN-?were significantly increased in ATBI patients compared with HCs,either.In distinguishing ATBI and LTBI patients,the area under the ROC curve(AUC)of combined the Treg cells and IFN-?was 0.848.In differentiating LTBI patients from HCs,the AUC of combined the CD3~+T cells,CD4~+HLA-DR~+cells and Il-6 was 0.923.In differentiating ATBI patients from HCs,the AUC of combined the CD3~+HLA-DR~+cells,CD4~+HLA-DR~+cells and IL-6 were 0.932.Conclusions:Combined detection of lymphocyte subsets,lymphocyte activation markers and extracellular cytokines are useful in distinguishing whether it is tuberculosis infection,as well as the latent and active period of infection,which has clinical application value.