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目的:分析IL-35、IL-17在人类免疫缺陷病毒混合结核感染中的免疫作用。方法:研究对象分为两组:抗逆转录病毒治疗(ART)组共80例;ART治疗前HIV-TB双重感染组共50例,通过ART治疗方案及抗结核治疗方案,采集和处理血液样本并进行检测分析。结果:HIV-TB合并感染者,与HIV感染组相比,经治疗后Th17细胞数量增加,Treg细胞数量下降,IL-35数量下降,IL-17数量上升。HIV-TB组内发生TB-IRIS的与不发生的相比,Th17降低,IL-35升高,IL-17降低。随着时间变化,IL-17显著下降(P<0.05),IL-35显著上升(P<0.05),Treg显著下降(P<0.01)。IL-17/Treg/IL-35免疫应答与TB-IRIS转归相关性的高低排序为IL-17、Treg、IL-35。除IL-17免疫应答与TB-IRIS转归呈正相关外,其余均呈负相关。在0.05的水平上,TB-IRIS转归与IL-17/Treg/IL-35免疫应答的相关系数显著。结论:推测在HIV-TB双重感染中,IL-35可能通过下调Treg细胞水平和上调IL-17表达水平促进HIV-TB双重感染患者特异性细胞免疫反应,打破机体细胞免疫调节平衡,导致TB-IRIS的发生。
OBJECTIVE: To analyze the immunological effects of IL-35 and IL-17 on human immunodeficiency virus (HIV) mixed TB infection. Methods: The subjects were divided into two groups: 80 cases in ART group; 50 cases in HIV-TB double infection group before ART treatment. Blood samples were collected and treated by ART treatment and anti-TB treatment And testing and analysis. Results: Compared with HIV-infected patients, the number of Th17 cells increased, the number of Treg cells decreased, the number of IL-35 decreased and the number of IL-17 increased after HIV-TB infection. Compared with non-occurrence of TB-IRIS in HIV-TB group, Th17 decreased, IL-35 increased and IL-17 decreased. IL-17 decreased significantly (P <0.05), IL-35 increased significantly (P <0.05), and Treg decreased significantly with time (P <0.01). The correlation between IL-17 / Treg / IL-35 immune response and TB-IRIS was ranked as IL-17, Treg and IL-35. In addition to the IL-17 immune response and TB-IRIS outcome was positively correlated, the rest were negative correlation. At the 0.05 level, there was a significant correlation between the TB-IRIS outcome and the IL-17 / Treg / IL-35 immune response. It is speculated that IL-35 might promote the specific cellular immune response in patients with HIV-TB double infection by down-regulating the level of Treg cells and up-regulating the expression of IL-17 in HIV-TB double infection, breaking the balance of cellular immune regulation and leading to TB- IRIS happened.