Clinical Medical College of Chengdu Medical College, Chengdu, China.
Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China.
Medicine (Baltimore). 2023 Jun 16;102(24):e34041. doi: 10.1097/MD.0000000000034041.
Interleukin-4 (IL-4) is an important cytokine in the Th2 differentiation of CD4+ T cells, which modulates immune responses and participates in host defense against Mycobacterium tuberculosis. The present study aimed to evaluate the significance of IL-4 concentration in patients with tuberculosis. Data from this study will be helpful in understanding the immunological mechanisms of tuberculosis and in clinical practice.
A data search was conducted from January 1995 to October 2022 in electronic bibliographic databases such as China National Knowledge Infrastructure, Wan Fang, Embase, Web of Science, and PubMed. The Newcastle-Ottawa Scale was used to assess the quality of the included studies. Heterogeneity between the studies was assessed using I2 statistics. Publication bias was determined by funnel plot, and Egger's test was used to confirm the presence of publication bias. All qualified studies and statistical analyses were performed using Stata 11.0.
Fifty-one eligible studies comprising 4317 subjects were included in the meta-analysis. The results depicted a considerably increased level of serum IL-4 in patients with tuberculosis than in the controls (standard mean difference [SMD] = 0.630, [95% confidence interval (CI), 0.162-1.092]). However, there was no significant difference in plasma IL-4 levels between patients with TB and controls (SMD = 0.290, [95% CI, -0.430 to 1.010]). In addition, the infection status, TB focus location, drug resistance, race, research design type, and detection method divided the subjects into different subgroups for the meta-analysis. The results of the comparison of healthy controls and TB subjects showed that in the Asian population, the serum IL-4 level in patients with TB was higher than that in controls (SMD = 0.887, [95% CI, 0.202 to -1.573]) and patients with active TB as well as people with pulmonary TB showed increased serum IL-4 levels compared to controls (SMD = 0.689, [95% CI, 0.152-1.226]). In the case of the control group with latent TB, the active TB group had higher serum IL-4 levels than the control group (SMD = 0.920, [95% CI, 0.387-1.452]).
The present meta-analysis showed that serum IL-4 varied in healthy individuals and patients with TB. Patients with active TB may also exhibit higher IL-4 concentrations.
白细胞介素 4（IL-4）是 CD4+T 细胞向 Th2 分化的重要细胞因子，它调节免疫反应并参与宿主对结核分枝杆菌的防御。本研究旨在评估结核患者中 IL-4 浓度的意义。本研究的数据将有助于了解结核病的免疫学机制，并有助于临床实践。
从 1995 年 1 月到 2022 年 10 月，我们在中文电子文献数据库（中国知网、万方、Embase、Web of Science 和 PubMed）中进行了数据检索。我们使用纽卡斯尔-渥太华量表来评估纳入研究的质量。使用 I2 统计量评估研究之间的异质性。通过漏斗图确定发表偏倚，并使用 Egger 检验确认是否存在发表偏倚。所有合格的研究和统计分析均使用 Stata 11.0 进行。
纳入的 51 项合格研究共包括 4317 名受试者。荟萃分析结果表明，结核患者的血清 IL-4 水平明显高于对照组（标准均数差 [SMD] = 0.630，[95%置信区间（CI），0.162-1.092]）。然而，结核患者与对照组之间的血浆 IL-4 水平没有显著差异（SMD = 0.290，[95%CI，-0.430 至 1.010]）。此外，根据感染状态、结核灶位置、耐药性、种族、研究设计类型和检测方法，将受试者分为不同的亚组进行荟萃分析。健康对照组和结核组比较的结果表明，在亚洲人群中，结核患者的血清 IL-4 水平高于对照组（SMD = 0.887，[95%CI，0.202 至-1.573]），且活动期结核患者和肺结核患者的血清 IL-4 水平也高于对照组（SMD = 0.689，[95%CI，0.152 至 1.226]）。对于潜伏性结核对照组，活动期结核组的血清 IL-4 水平高于对照组（SMD = 0.920，[95%CI，0.387 至 1.452]）。
本荟萃分析表明，血清 IL-4 在健康个体和结核患者中存在差异。活动期结核患者的 IL-4 浓度可能也会升高。
