St. Petersburg State University, St. Petersburg, Russia.
St. Petersburg Research Institute of Phthisiopulmonology, St. Petersburg, Russia.
Front Immunol. 2023 Jan 25;13:1059714. doi: 10.3389/fimmu.2022.1059714. eCollection 2022.
Pathogenesis of many autoimmune diseases is mainly promoted by poorly regulated and/or wrong targeted immune response to pathogens including . Autoimmunity is one of the processes with are characteristics of tuberculosis (Tbc). The aim was to determine the autoimmune clinical and immunological features in patients with pulmonary Tbc.
A prospective comparative study was performed in 2017 - 2019 with the inclusion of 46 patients with Tbc. The trigger factors and clinical manifestations, autoantibodies, peripheral blood B cell subsets were stained with fluorochrome-conjugated monoclonal antibodies. 40 healthy volunteers in the control group, were matched for age with no chronic diseases, contacts with TB patients and changes in their laboratory parameters. A statistical analysis was done with GraphPad Prism 6, Statistica 10 (Statsoft) and MedCalc - version 18.2.1 values.
There were no significant ASIA triggers in Tbc patients and control group. 21.1% of Tbc patients had a high level of a rheumatoid factor and in 47.4% complement system factor C3 was high; anti-MCV was detected in 60.7% of Tbc patients. Relative and absolute frequencies of "naïve" Bm1 cells and eBm5 were significantly decreased and activated pre-germinal-center Bm2' cells were significantly increased in Tbc patients. The CD24++CD38++ B cells were increased in Tbc vs control group (10.25% vs 5.42%), p < 0.001, and 19 cell/1μL (10; 290 vs 11 cell/1μL (6; 20), p = 0.029, respectively). The frequency of CXCR3+CCR4- Tfh1 cells was significantly lower in Tbc vs control one (26.52% vs. 31.00%, p = 0.004), while CXCR3-CCR4+ Tfh2 cells were increased in Tbc (20.31% vs. controls (16.56%, p = 0.030). The absolute numbers of Tfh1 cells were decreased in the Tbc vs. control (24 cell/1μL vs. 37 cell/1μL p = 0.005).
The results of our study showed that the detection of a rheumatoid factor, the components of complement system and anti-MCV in complex with alterations in B cells and follicular Th cell subsets may indicate a presence of autoimmunity in the pathogenesis of tuberculosis, but they are not specific. The indicators of autoimmune-related provide new opportunities in the Tbc treatment.
许多自身免疫性疾病的发病机制主要是由于对病原体（包括）的免疫反应调节不良和/或靶向错误。自身免疫是结核病（Tbc）的特征之一。目的是确定肺结核患者的自身免疫临床和免疫学特征。
2017-2019 年进行了一项前瞻性对照研究，纳入 46 例肺结核患者。触发因素和临床表现、自身抗体、外周血 B 细胞亚群用荧光素标记的单克隆抗体染色。40 名健康志愿者作为对照组，与无慢性疾病、与结核患者接触和实验室参数变化的对照组相匹配。使用 GraphPad Prism 6、Statistica 10（Statsoft）和 MedCalc-版本 18.2.1 进行统计分析。
肺结核患者和对照组均无明显的 ASIA 触发因素。21.1%的肺结核患者类风湿因子水平升高，47.4%的补体因子 C3 升高；60.7%的肺结核患者检测到抗-MCV。肺结核患者中“幼稚”Bm1 细胞和 eBm5 的相对和绝对频率明显降低，生发中心前 Bm2'细胞明显增加。与对照组相比，肺结核患者的 CD24++CD38++B 细胞增加（10.25%比 5.42%，p<0.001），19 个细胞/μL（10；290 个比 11 个细胞/μL（6；20），p=0.029）。与对照组相比，肺结核患者中 CXCR3+CCR4-Tfh1 细胞的频率明显降低（26.52%比 31.00%，p=0.004），而 CXCR3-CCR4+Tfh2 细胞则增加（20.31%比对照组（16.56%，p=0.030）。与对照组相比，Tfh1 细胞的绝对数量减少（24 个细胞/μL 比 37 个细胞/μL，p=0.005）。
我们的研究结果表明，检测类风湿因子、补体系统成分和抗-MCV 与 B 细胞和滤泡 Th 细胞亚群的改变相结合，可能表明自身免疫在结核病发病机制中存在，但它们不是特异性的。自身免疫相关指标为肺结核的治疗提供了新的机会。
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