Ameglio F, Casarini M, Capoluongo E, Mattia P, Puglisi G, Giosuè S
Department of Clinical Pathology, General Hospital S Giovanni Calibita, Roma, Italy.
Int J Tuberc Lung Dis. 2005 Jan;9(1):98-104.
Little information is available regarding the relationship between the fibrotic evolution of pulmonary tuberculosis (PTB) and cytokine levels in human bronchoalveolar lavage fluid (BALF) and serum.
To evaluate correlations between profibrotic cytokine levels and post-treatment lung fibrotic evolution.
BALF and serum amounts of pro- or anti-inflammatory cytokines were obtained by ELISA before and 6 months after the start of anti-tuberculosis chemotherapy in 13 subjects with PTB. BALF levels were recalculated as ELF (epithelial lining fluid) levels by the urea method. High resolution computed tomography (HRCT) of both lungs was performed at the same time.
When comparing pre- and post-treatment radiological data, the scores for 2-10 mm nodules, consolidation and fibrosis presented significant differences (P < 0.05). Concomitantly, pre-treatment vs. 6 month concentrations of ELF IFN-gamma and TNF-alpha were decreased (P < 0.05), while those of IL-4 and IL-10 were increased (P < 0.012). At serum level, IFN-gamma decreased, as did TNF-alpha, TGF-beta1 and PDGF-BB (P < 0.05). When the patients were subdivided into two groups, 1) stable or 2) increasing HRCT fibrosis score, significant increases in the second group were observed for ELF/ serum values of TGF-beta1 and ELF PDGF-BB (P < 0.05) at 6 months post-treatment. Only serum TGF-beta1 values were significantly associated with the same group before treatment.
关于肺结核（PTB）纤维化演变与人类支气管肺泡灌洗液（BALF）和血清中细胞因子水平之间的关系，目前可用信息较少。
评估促纤维化细胞因子水平与治疗后肺部纤维化演变之间的相关性。
对13例PTB患者在抗结核化疗开始前及开始后6个月，通过酶联免疫吸附测定（ELISA）获取BALF和血清中促炎或抗炎细胞因子的含量。采用尿素法将BALF水平重新计算为上皮衬液（ELF）水平。同时对双肺进行高分辨率计算机断层扫描（HRCT）。
比较治疗前后的放射学数据时，2 - 10毫米结节、实变和纤维化的评分存在显著差异（P < 0.05）。同时，治疗前与6个月时ELF中干扰素-γ（IFN-γ）和肿瘤坏死因子-α（TNF-α）的浓度降低（P < 0.05），而白细胞介素-4（IL-4）和白细胞介素-10（IL-10）的浓度升高（P < 0.012）。在血清水平，IFN-γ降低，TNF-α、转化生长因子-β1（TGF-β1）和血小板衍生生长因子-BB（PDGF-BB）也降低（P < 0.05）。当将患者分为两组时，1）稳定组或2）HRCT纤维化评分增加组，治疗后6个月时第二组的TGF-β1的ELF/血清值和ELF PDGF-BB显著增加（P < 0.05）。只有血清TGF-β1值与治疗前的同一组显著相关。
