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Carrimycin in the treatment of acute promyelocytic leukemia combined with pulmonary tuberculosis: A case report

World Journal of Clinical Cases 2024年第3期12卷 623-629页

作者： Fu-Yu Yang Lei Shao Jie Su Zhen-Meng Zhang Department of Infectious Diseases The Affiliated Central Hospital of Shandong First Medical UniversityJinan 250013Shandong ProvinceChina

BACKGROUND pulmonary tuberculosis(PTB)is prevalent in immunocompromised populations,including patients with hematologic malignancies,human immunodeficiency virus infections,and chronic diseases.Effective treatment for acute promyelocytic leukemia(APL)combined with PTB is lacking.These patients show an extremely poor prognosis.Therefore,studies should establish efficient treatment options to improve patient survival and prognosis.CASE SUMMARY A 60-year-old male with pain in the right side of his chest and a fever for 4 d visited the outpatient department of our hospital.Peripheral blood smear revealed 54%blasts.Following bone marrow examinations,variant APL with TNRC18-RARA fusion gene was diagnosed.Chest computed tomography scan showed bilateral pneumonitis with bilateral pleural effusions,partial atelectasis in the lower lobes of both lungs,and the bronchoalveolar lavage fluid gene X-Pert test was positive,indicative of PTB.Carrimycin,ethambutol(EMB),and isoniazid(INH)were administered since he could not receive chemotherapy as the WBC count decreased continuously.After one week of treatment with carrimycin,the patient recovered from fever and received chemotherapy.Chemotherapy was very effective and his white blood cells counts got back to normal.After being given five months with rifampin,EMB and INH and chemotherapy,the patient showed complete remission from pneumonia and APL.CONCLUSION We report a case of PTB treated successfully with carrimycin with APL that requires chemotherapy.

关键词： Carrimycin Hematologic disease Acute myeloid leukemia Acute promyelocytic leukemia pulmonary tuberculosis Case report

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Analysis of the influencing factors and clinical related characteristics of pulmonary tuberculosis in patients with type 2 diabetes mellitus

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World Journal of Diabetes 2024年第2期15卷 196-208页

作者： Han Shi Yuan Yuan Xue Li Yan-Fang Li Ling Fan Xue-Mei Yang Department of Infectious Diseases The First Affiliated Hospital of Chengdu Medical CollegeChengdu 610500Sichuan ProvinceChina

BACKGROUND In China,the prevalence of type 2 diabetes mellitus(T2DM)among diabetic patients is estimated to be between 90%-95%.Additionally,China is among the 22 countries burdened by a high number of tuberculosis cases,with approximately 4.5 million individuals affected by active tuberculosis.Notably,T2DM poses a significant risk factor for the development of tuberculosis,as evidenced by the increased incidence of T2DM coexisting with pulmonary tuberculosis(T2DMPTB),which has risen from 19.3%to 24.1%.It is evident that these two diseases are intricately interconnected and mutually reinforcing in nature.AIM To elucidate the clinical features of individuals diagnosed with both T2DM and tuberculosis(T2DM-PTB),as well as to investigate the potential risk factors associated with active tuberculosis in patients with T2DM.METHODS T2DM-PTB patients who visited our hospital between January 2020 and January 2023 were selected as the observation group,Simple DM patients presenting to our hospital in the same period were the control group,Controls and case groups were matched 1:2 according to the principle of the same sex,age difference(±3)years and disease duration difference(±5)years,patients were investigated for general demographic characteristics,diabetes-related characteristics,body immune status,lifestyle and behavioral habits,univariate and multivariate analysis of the data using conditional logistic regression,calculate the odds ratio(OR)values and 95%CI of OR values.RESULTS A total of 315 study subjects were included in this study,including 105 subjects in the observation group and 210 subjects in the control group.Comparison of the results of both anthropometric and biochemical measures showed that the constitution index,systolic blood pressure,diastolic blood pressure and lymphocyte count were significantly lower in the case group,while fasting blood glucose and high-density lipoprotein cholesterol levels were significantly higher than those in the control group.The results of univariate analysis showed that poo

关键词： Type 2 diabetes pulmonary tuberculosis Blood sugar Infection Risk factors

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3-to 24-month Follow-up on COVID-19 with pulmonary tuberculosis Survivors after Discharge:Results from a Prospective,Multicenter Study

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Biomedical and Environmental Sciences 2022年第12期35卷 1091-1099页

作者： WANG Jing Ya ZONG Xing Yu WU Gui Hui QI Yuan Lin LI Hui Zhen JI Xin Yu TONG Lin ZHANG Lei YANG Ming Bo YANG Pu Ye LI Ji Ke XIAO Fu Rong ZHANG Lin Song HU Yun Hong LIU Hong De XU Shou Fang SUN Sheng WU Wei MAO Ya LI Min Qing HOU Hao Hua GONG Zhao Yuan GUO Yang JIAO Li Wen QIN Jin WANG Ding Yi WANG Fang GUAN Li LIN Gang MA Yan WANG Yan Ping SHI Nan Nan Community Health Service Management Center Dongcheng DistrictBeijing 100700China Institute of Basic Research in Clinical Medicine China Academy of Chinese Medical SciencesBeijing 100700China Public Health Clinical Center of Chengdu Chengdu 610066SichuanChina Yiyuan TCM Hospital Zibo 256199ShandongChina Institute of Information on Traditional Chinese Medicine China Academy of Chinese Medical SciencesBeijing 100700China Xi’an Eighth Hospital Xi’an 710000ShaanxiChina Harbin Infectious Disease Hospital Harbin 150000HeilongjiangChina Hospital(T.C.M)Affiliated to Southwest Medical University Luzhou 646000SichuanChina Xingtai Hospital of Chinese Medicine Xingtai 054000HebeiChina Shijiazhuang Fifth Hospital Shijiazhuang 050000HebeiChina Jiamusi Infectious Disease Hospital Jiamusi 154000HeilongjiangChina Chengde Hospital of Traditional Chinese Medicine Chengde 067040HebeiChina Hanzhong Central Hospital Hanzhong 723000ShaanxiChina Ankang Hospital of Traditional Chinese Medicine Ankang 725000ShaanxiChina Department of Traditional Chinese medicine Dazhou Central HospitalDazhou 635000SichuanChina China National Medicines Corporation Ltd Beijing 100077China Beijing University of Chinese Medicine Beijing 101121China Infectious Disease Hospital of Heilongjiang Province Harbin 150030HeilongjiangChin

Objective Coronavirus disease 2019(COVID-19)and tuberculosis(TB)are major public health and social issues worldwide.The long-term follow-up of COVID-19 with pulmonary TB(PTB)survivors after discharge is unclear.This study aimed to comprehensively describe clinical outcomes,including sequela and recurrence at 3,12,and 24 months after discharge,among COVID-19 with PTB survivors.Methods From January 22,2020 to May 6,2022,with a follow-up by August 26,2022,a prospective,multicenter follow-up study was conducted on COVID-19 with PTB survivors after discharge in 13 hospitals from four provinces in China.Clinical outcomes,including sequela,recurrence of COVID-19,and PTB survivors,were collected via telephone and face-to-face interviews at 3,12,and 24 months after discharge.Results Thirty-two COVID-19 with PTB survivors were included.The median age was 52(45,59)years,and 23(71.9%)were men.Among them,nearly two-thirds(62.5%)of the survivors were moderate,three(9.4%)were severe,and more than half(59.4%)had at least one comorbidity(PTB excluded).The proportion of COVID-19 survivors with at least one sequela symptom decreased from 40.6%at 3 months to 15.8%at 24 months,with anxiety having a higher proportion over a follow-up.Cough and amnesia recovered at the 12-month follow-up,while anxiety,fatigue,and trouble sleeping remained after 24months.Additionally,one(3.1%)case presented two recurrences of PTB and no re-positive COVID-19during the follow-up period.Conclusion The proportion of long symptoms in COVID-19 with PTB survivors decreased over time,while nearly one in six still experience persistent symptoms with a higher proportion of anxiety.The recurrence of PTB and the psychological support of COVID-19 with PTB after discharge require more attention.

关键词： COVID-19 pulmonary tuberculosis Long-term Sequela Recurrence Re-positive

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Epidemiological characteristics of pulmonary tuberculosis in patients with pneumoconiosis based on its social determinants and risk factors in China:a cross-sectional study from 27 provinces

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Chinese Medical Journal 2022年第24期135卷 2984-2997页

作者： Huanqiang Wang Huaping Dai Jiayu He Xiangpei Lyu Xinran Zhang Tao Li Department of Occupational Respiratory Disease National Institute for Occupational Health and Poison ControlChinese Center for Disease Control and PreventionBeijing 100050China National Center for Respiratory Medicine National Clinical Research Center for Respiratory DiseasesInstitute of Respiratory MedicineChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100029China Department of pulmonary and Critical Care Medicine Center of Respiratory MedicineChina-Japan Friendship HospitalBeijing 100029China Department of Clinical Research and Data Management Center of Respiratory MedicineChina-Japan Friendship HospitalBeijing 100029China

Background:Patients with pneumoconiosis have an elevated risk of contracting pulmonary tuberculosis(PTB)and need particular attention.However,extensive population-based studies on the prevalence of PTB in patients with pneumoconiosis have not been reported in China since 1992.This study aimed to investigate the epidemiological characteristics of PTB in patients with pneumoconiosis based on its social determinants and risk factors in China.Methods:Based on the Commission on Social Determinants of Health(CSDH)framework,data were obtained from a questionnaire survey of patients with pneumoconiosis from China’s 27 provinces(autonomous regions,municipalities)from December 2017 to June 2021.By chi-square and multivariate logistic regression analyses,the epidemiological characteristics of PTB in the patients were identified based on its prevalence and odds ratio(OR)and associated social determinants and risk factors.The population attributable fractions(PAFs)of significant risk factors were also calculated.Results:The prevalence of PTB in patients with pneumoconiosis(n=10,137)was 7.5%(95%confidence interval[CI]:7.0-8.0%).Multivariate logistic regression analysis showed that risk factors included in-hospital exposure to patients with PTB(OR=3.30,95%CI:2.77-3.93),clinically diagnosed cases(OR=3.25,95%CI:2.42-4.34),and northeastern regions(OR=2.41,95%CI:1.76-3.31).In addition,lack of work-related injury insurance(WRII),being born in a rural area,being unemployed,living in western regions,household exposure to patients with PTB,smoking,being underweight,complications of pulmonary bullae or pneumothorax,hospitalization history,and former drinkers among the rural patients were also statistically significant risk factors.Being born in a rural area,lack of WRII and in-hospital exposure to patients with PTB had higher PAFs,which were 13.2%(95%CI:7.9-18.5%),12.5%(95%CI:8.3-16.7%),and 11.6%(95%CI:8.8-14.3%),respectively.Conclusion:The prevalence of PTB in pneumoconiosis remains high in China;it is basically in line with the CSDH m

关键词： pulmonary tuberculosis Pneumoconiosis Social determinants Risk factors

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Age-period-cohort analysis of pulmonary tuberculosis reported incidence, China, 2006-2020

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Infectious Diseases of Poverty 2022年第4期11卷 62-71页

作者： Zhe Dong Qi-Qi Wang Shi-Cheng Yu Fei Huang Jian-Jun Liu Hong-Yan Yao Yan-Lin Zhao Chinese Center for Disease Control and Prevention BejingChina

Background:tuberculosis(TB)poses a severe public health challenge in China and worldwide.This study evaluated the effects of age,period,and birth cohort on reported incidence trends of TB based on population and refined the characteristics of high-risk groups.Methods:Aggregate data that reported pulmonary tuberculosis(PTB)cases from China tuberculosis Management Information System(TBIMS)from 2006 to 2020 were used to analyze effect coefficients through the age-period-cohort(APC)model based on intrinsic estimator(IE)method,and converted them into relative risk(RR)to estimate trends.Results:A total of 14.82 million cases of PTB were reported in China from 2006 to 2020,showing a continuous downward trend.The reporting rate increased with age by age group,with 70-74 years old being 2-3 times higher than that in 20-24 years old.APC analysis model showed that age effects were bimodal in 20-24 years old[RR=2.29,95%confidence interval(CI):1.73-3.03]and 70-74 years old(RR=1.95,95%CI:1.67-2.27),and lower than the overall average in the groups under 15 years old.Stratified results showed that the risk was higher for women under age 40 than men and higher for men over 40.The risk was higher in urban than in rural areas under 30 years old and slightly higher in rural than in urban between 30 and 64 years old.The risk for 15-34 years old was significantly higher in the east than in other regions.The period effects showed a decreasing trend,and the risk was higher in rural in recent years.Except for cohorts born in 1961-1965 and 2001-2005,where theRR increased,the later the cohort was born,the lower the risk.The cohort 1926-1930 in eastern had the highest risk(RR=3.49,95%CI:2.44-4.98).Conclusions:The reported incidence of PTB continued to decline in China from 2006 to 2020.The young(20-24 years old)and the elderly(70-74 years old)were equally at high risk.There were differences in the age,period and cohort effects on PTB incidence among gender,urban-rural and regions.Our findings better reflected the characteristics of high-ris

关键词： pulmonary tuberculosis Reported incidence Age-period-cohort model China

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Association between depression and malnutrition in pulmonary tuberculosis patients:A cross-sectional study

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World Journal of Clinical Cases 2022年第14期10卷 4395-4403页

作者： Xue-E Fang Dan-Ping Chen Ling-Ling Tang Yan-Jun Mao Department of tuberculosis Shanghai Pulmonary Hospital Affiliated to Tongji UniversityShanghai 200000Shanghai ProvinceChina Department of Nursing Shanghai Pulmonary Hospital Affiliated to Tongji UniversityShanghai 200000Shanghai ProvinceChina

BACKGROUND Depression has been reported to be prevalent in patients with pulmonary tuberculosis(PTB).Moreover,several clinical symptoms of PTB and depression overlap,such as loss of appetite and malnutrition.However,the association between depression and malnutrition in TB patients has not been fully elucidated.AIM To explore the association between depression and malnutrition in patients with PTB.METHODS This hospital-based cross-sectional study included patients with PTB in Shanghai pulmonary Hospital Affiliated to Tongji University from April 2019 to July 2019.The Patient Health Questionnaire-9(PHQ-9)scale was used to evaluate depression.The cut-off value was set at 10,and the nutritional state was determined by the body mass index(BMI).In addition,the Quality of Life Instruments for Chronic Diseases was employed to establish the quality of life(QOL).Univariable analysis and multivariable analysis(forward mode)were implemented to identify the independent factors associated with depression.RESULTS A total of 328 PTB patients were screened for analysis.Eight were excluded for missing demographic data,four excluded for missing nutrition status,and sixteen for missing QOL data.Finally,300 PTB patients were subjected to analysis.We found that depressive state was present in 225 PTB patients(75%).The ratio of malnutrition in the depressive PTB patients was 45.33%.Our results revealed significantly lower BMI,hemoglobin,and prealbumin in the depression group than in the control group(P<0.05).Moreover,the social status differed significantly(P<0.05)between the groups.In addition,glutamic pyruvic transaminase and glutamic oxaloacetic transaminase in the depression group were significantly higher than those in the control group(P<0.05).Multivariable logistic regression analysis showed that BMI[odds ratio(OR)=1.21,95%confidence interval(CI):1.163-1.257,P<0.001]and poor social function(OR=0.95,95%CI:0.926-0.974,P=0.038)were independently associated with depression.CONCLUSION Malnutrition and poor social function are signif

关键词： Depression pulmonary tuberculosis Malnutrition Quality of life Comorbidity China

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XpertMTB/RIF Assay for the Diagnosis of pulmonary tuberculosis Based on Bronchoalveolar Lavage Fluid:A Systematic Review and Meta-analysis

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感染微生物与疾病(英文) 2023年第3期5卷 111-119页

作者： Hao-Kai Chen Chun-Xi Lin Peng-Li Lv Wen-Feng Li Yu-Ying Feng Xue-Jia Deng Jia-Qi Xiao Xu-Guang Guo Department of Clinical Laboratory Medicine The Third Affiliated Hospital of Guangzhou Medical UniversityGuangzhouChina Department of Clinical Medicine The Third Clinical School of Guangzhou Medical UniversityGuangzhouChina Department of Clinical Medicine Nanshan College of Guangzhou Medical UniversityGuangzhouChina Guangdong Provincial Key Laboratory of Major Obstetric Diseases The Third Affiliated Hospital of Guangzhou Medical UniversityGuangzhouChina Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes The Third Affiliated Hospital of Guangzhou Medical UniversityGuangzhouChina Guangzhou Key Laboratory for Clinical Rapid Diagnosis and Early Warning of Infectious Diseases KingMed School of Laboratory MedicineGuangzhou Medical UniversityGuangzhouChina

Currently,tuberculosis(TB)is the second most lethal disease in the world caused by a single infectious pathogen.Rapid diagnosis of TB is of great importance for its treatment and management.Xpert MTB/RIF is a novel rapid diagnostic assay for the diagnosis of pulmonary TB(PTB).Use of the Xpert assay based on bronchoalveolar lavage fluid(BALF)samples is indicated when TB is suspected and sputum smears or cultures are negative.The aim of this meta-analysis was to systematically evaluate the diagnostic performance of the Xpert assay based on BALF samples for the diagnosis of PTB.A systematic review of previously published articles was performed,and rel-evant data were extracted.Meta-DiSc 1.4 and Stata 12.0 were used to analyze the data.When Mycobacterium tuberculosis cultures were used as the criterion standard,the combined sensitivity of BALF-based Xpert was 0.89(95%CI,0.87–0.91),the specificity was 0.87(95%CI,0.85-0.88),the positive likelihood ratio was 8.28(95%CI,5.39–12.71),the negative likelihood ratio was 0.14(95%CI,0.10–0.19)and the diagnostic ratio was 84.08(95%CI,42.00–168.31).When composite reference standard was used as the criterion standard,the above observations were 0.69(95%CI,0.67–0.72),0.98(95%CI,0.97–0.98),41.40(95%CI,14.56–117.71),0.28(95%CI,0.21–0.37)and 190.47(95%CI,50.56–717.54),respectively.The area under the summary receiver operating characteristic curve was close to 1 for both.Overall,the Xpert MTB/RIF assay based on BALF samples showed high sensitivity and specificity for the diag-nosis of PTB and seems to be a reliable rapid detection method.

关键词： Xpert MTB/RIF pulmonary tuberculosis bronchoalveolar lavage fluid meta-analysis

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Determination of the predictive factors for diagnostic positivity of nucleic acid amplification tests for diagnosing pulmonary tuberculosis

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Infectious Medicine 2022年第1期1卷 17-22页

作者： Xingfang Hou Qinglong Guo Qiao Lin Taosheng Ye Jing Bi Juan Liang Ke Yang Yuan Zhou Juanjuan Zhang Zhihang Liang Xuefeng Zhou Gengwei Zhang Xiangdong Fu Hongjian Zhong Guoliang Zhang Department of Respiratory Medicine The First Hospital of ChangshaChangsha 410005China National Clinical Research Center for Infectious Diseases Shenzhen Third People’s HospitalSouthern University of Science and TechnologyShenzhen 518112China Department of Traditional Chinese Medicine Affiliated Baoan Hospital of Southern Medical UniversityThe Baoan People’s Hospital of ShenzhenShenzhen 518101China Biomedical Translational Research Institute Faculty of Medical ScienceJinan UniversityGuangzhou 510632China.

Background:tuberculosis(TB)remains a major threat to human health,and TB diagnostic methods remain unsatisfactory.Nucleic acid amplification tests(NAATs)show higher sensitivity compared with culture for the diagnosis of pulmonary TB(PTB).However,NAATs are expensive and cannot be easily implemented outside major medical centers.To improve the sensitivity of NAATs for PTB diagnosis,we investigated the predictive factors that might optimize NAAT utilization.Methods:A total of 1263 patients with suspected PTB were enrolled for evaluation.The sensitivity,specificity,and accuracy of methods including smear-microbiology,culture of Mtb and NAAT for Mycobacterium tuberculosis(Mtb)detection in sputum and bronchoalveolar lavage fluid samples were compared.Odds ratios and 95%confidence intervals were used to assess variables that might be associated with positive NAAT results for sputum and bronchoalveolar lavage fluid from patients with suspected PTB.Results:NAAT showed higher sensitivity for Mtb detection(61.1%)when compared with smear(9.0%)and Mtb culture(47.8%).We found that an elevated erythrocyte sedimentation rate,the presence of cavities,and positive interferon-𝛾release assay(IGRA)results were indicative of positive Mtb detection by NAAT.Moreover,individuals who had all three of these characteristics showed an 86%diagnostic positivity for PTB from Mtb detection by NAAT.Conclusions:Our study suggests that an elevated erythrocyte sedimentation rate,a positive IGRA result,and the presence of pulmonary cavities are helpful factors for predicting positive Mtb detection by NAAT.Patients with the three positive clinical markers should undergo NAAT for Mtb detection because they are the most likely individuals to be bacteriologically confirmed as having TB.

关键词： pulmonary tuberculosis Nucleic acid amplification tests Indicators Detection Mycobacterium tuberculosis

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pulmonary tuberculosis manifesting as‘tree-in-bud’opacities on chest radiography

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Family Medicine and Community Health 2013年第1期1卷 53-55页

作者： RUMI R.KHAJOTIA SANGEETHA POOVANESWARAN Internal Medicine and Pulmonology International Medical University Clinical SchoolMalaysia Internal Medicine International Medical University Clinical SchoolMalaysia

Background The‘tree-in-bud’pattern is an appearance typically seen on HRCT or thin-section computed tomography(CT)chest scan.It is characterized by small centrilobular nodules of soft-tissue attenuation connected to... 详细信息

关键词： pulmonary tuberculosis Tree-in-Bud pattern HRCT chest scan

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Interleukin 17-Producing γδ T Cells Increased in Patients with Active pulmonary tuberculosis

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Cellular & Molecular Immunology 2008年第3期5卷 203-208页

作者： Meiyu Peng Zhaohua Wang Chunyan Yao Lina Jiang Qili Jin Jing Wang Baiqing Li Department of Immunology Bengbu Medical College and Anhui KeyLaboratory of Infection and Immunity at Bengbu Med cal College 2600Dong hai Avenue Bengbu Anhui 233030 China The Infectious Disease Hospital of Bengbu 160 Third Hongqi RoadBengbu Anhui 233000 China Department of Immunology Bengbu Medical College 2600 Dong Hal Avenue Bengbu Anhui 233030 China

Although it has been known that γδ T cells may play an important role in the immune response to infection of Mycobacterium tuberculosis （M. tb）, the mechanisms by which the γδ T cells participate in the innate and/or acquired immunity to tuberculosis （TB） have not been full elucidated. In the present study, 27 patients with active pulmonary TB and 16 healthy donors （HD） were performed. We found that proportion of IL-17-producing cells among lymphocyte was similar between TB patients and HD, whereas the proportions of γδ T cells in IL-17-producing cells （59.2%） and IL-17-producing cells in γδ T cells （19.4%） in peripheral blood were markedly increased in TB patients when compared to those in HD （43.9% and 7.7%, respectively）. In addition, the proportions of IFN-T-producing γδ T cells in TB patients were obviously lower than that in HD. Upon re-stimulated with M. tb heat-treated antigen （M. tb-HAg） in vitro, fewer IL-17-producing γδ T cells were generated from HD and TB patients, whereas IFN-T-producing γδ T cells were increased in TB patients compared to that in HD. Our findings in TB patients and healthy human were consistent with other murine investigation that the IL-17- producing γδ T cells were main source of IL-17 in mouse model of BCG infection, suggesting that γδ T cells might be involved in the formation of tubercular granuloma in pulmonary TB patients, but need further identification.

关键词： Mycobacterium tuberculosis γδ T cell IL-17 pulmonary tuberculosis

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