Objective To discuss the effect of TH17 cells and cytokines on the recurrence of spinal tuberculosis was evaluated in hypoxic environment.Methods From September 2015 to January 2017,in Qinghai People's Hospital,46 patients with spinal tuberculosis were selected,they were divided into primary group (27 cases) and recurrence group (19 cases) according to clinical manifestation and laboratory examination.TH17 cells and cytokines including IL-6,IL-1β,IL-23,TNF-α,IFN-γin patients and the CCL20,CCL22,CCL27 were detected.The relationship of chemotactic index of Th17 cells and the Th17 expression of CCR receptor and CCL ligand were evaluated.Results Compared with primary group,the percentage of TH17 cells increased significantly of patients in recurrence group (P ＜ 0.05),the content of cytokines including IL-6,IL-1,IL-23,TNF-α increased significantly (P ＜ 0.01),the content of IFN-γ decreased (P ＜ 0.01).The concentration of CCL20,CCL22 and CCL27 from recurrent group were significantly higher than primary group (P ＜ 0.01),immunofluorescence staining and scanning quantitative analysis showed that the expression of CCL20,CCL22 and CCL27 in bone cells of patients in recurrent group were higher than in primary group (P ＜ 0.01),cell morphology was similar with the the staining results of primary group.Conclusion Th17 cells can be used for the diagnosis of tuberculosis and tuberculosis recurrence,differentiation of tuberculosis courses and evaluation of immune function of patients.IL-6,IL-1 β,IL-23,TNF-α,IFN-γ,CCL20,CCL22,CCL27,CCR receptors and CCL ligands can be used as a new diagnostic marker for the recurrence of spinal tuberculosis in hypoxia,and for the early diagnosis of tuberculosis recurrence.%目的 探讨TH17细胞及细胞因子在缺氧环境下在脊柱结核患者复发机制的影响.方法 选择2015年9月～2017年1月青海省人民医院就诊的脊柱结核病患者46例,依据临床表现和实验室检查将其分为初发组(27例)和复发组(19例).对患者TH17细胞及细胞因子IL-6、IL-1β、IL-23、TNF-α及IFN-γ进行检测,并对CCL20、CCL22、CCL27进行检测,观察Th17细胞趋化指数变化及Th17细胞表达CCR受体及CCL配体的关系.结果 与初发组比较,复发组患者的TH17细胞比例明显升高(P＜0.05),细胞因子IL-6、IL-1β、IL-23、TNF-α含量明显上升(P＜0.01),IFN-γ含量下降(P＜0.01).复发组CCL20、CCL22、CCL27的浓度明显高于初发组(P＜0.01),免疫荧光染色及扫描定量分析发现CCL20、CCL22、CCL27在复发组患者的骨细胞中表达高于初发组(P＜0.01),细胞形态与初发组染色结果均相似.结论 可将Th17细胞用于结核病及结核复发的诊断、结核病不同病程的区分及患者免疫功能的评估.可将IL-6、IL-1β、IL-23、TNF-α、IFN-γ、CCL20、CCL22、CCL27、CCR受体及CCL配体作为缺氧条件下脊柱结核复发新的诊断标志物,用于结核病复发的早期诊断.
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