HIV-1感染合并结核病患者中结核分枝杆菌诱导的细胞因子反应

Cytokine responses induced by Mycobacterium tuberculosis in patients with HIV-1 infection and tuberculosis.

作者信息

Oh Myoung-Don, Kang Cheol-In, Kim Ui-Seok, Kim Nam Joong, Lee Bobin, Kim Hong Bin, Choe Kang Won

机构信息

Department of Internal Medicine, Seoul National University College of Medicine, Seoul, 110-744, Republic of Korea.

出版信息

Int J Infect Dis. 2005 Mar;9(2):110-6. doi: 10.1016/j.ijid.2004.05.009.

DOI:10.1016/j.ijid.2004.05.009

PMID:15708327

Abstract

OBJECTIVE

Tuberculosis (TB) is an important opportunistic infection in HIV patients. Immune responses to Mycobacterium tuberculosis in HIV/TB patients were evaluated.

METHODS

Fifteen patients with HIV/TB, ten with HIV, four with TB, and five controls were enrolled. Peripheral blood mononuclear cells were isolated and stimulated with mycobacterial antigen (PPD). Interferon (IFN)-gamma and TNF-alpha in culture supernatants were measured by ELISA.

RESULTS

IFN-gamma and TNF-alpha production after PPD stimulation was markedly decreased in HIV patients, but not in HIV/TB patients. In HIV patients with a CD4 cell count of less than 200/mm3, IFN-gamma and TNF-alpha production after PPD stimulation was higher in HIV/TB patients than in HIV patients. Cytokine responses to M. tuberculosis reconstituted after highly active antiretroviral therapy (HAART) and were prominent in HIV/TB patients.

CONCLUSIONS

Cytokine responses to M. tuberculosis were retained in HIV-infected patients with tuberculosis, even in patients with a CD4 cell count of less than 200/mm3, and reconstituted after HAART.

摘要

目的

结核病（TB）是HIV患者重要的机会性感染。对HIV/TB患者针对结核分枝杆菌的免疫反应进行了评估。

方法

纳入15例HIV/TB患者、10例HIV患者、4例TB患者和5例对照。分离外周血单个核细胞并用分枝杆菌抗原（PPD）刺激。通过ELISA检测培养上清液中的干扰素（IFN）-γ和肿瘤坏死因子（TNF）-α。

结果

PPD刺激后，HIV患者中IFN-γ和TNF-α的产生明显减少，但HIV/TB患者中未减少。在CD4细胞计数低于200/mm3的HIV患者中，PPD刺激后HIV/TB患者中IFN-γ和TNF-α的产生高于HIV患者。细胞因子对结核分枝杆菌的反应在高效抗逆转录病毒治疗（HAART）后得以恢复，且在HIV/TB患者中较为显著。