Immunomodulatory effect of urinary trypsin inhibitor on patients with severe tuberculosis

doi:10.3877/cma.j.issn.1674-6880.2018.06.003

Abstract

Abstract:

Objective

To explore the immunomodulatory effect of urinary trypsin inhibitor (UTI) on patients with severe tuberculosis.

Methods

Totally 84 patients with severe tuberculosis admitted to Hangzhou Red Cross Hospital from January 2015 to November 2017 were randomly divided into the UTI group and control group, with 42 cases in each group. The control group was given conventional treatment, while the UTI group received intravenous injection of UTI, 100 000 units every 8 hours for 7 days on the second day of admission to ICU based on conventional treatment. The general information, acute physiology and chronic health evaluation (APACHE) Ⅱ score, and expressions of interleukin-2 (IL-2), IL-6, IL-10, IL-12, interferon-gamma (INF-γ), transforming growth factor-beta (TGF-β), tumor necrosis factor-alpha (TNF-α), CD4⁺T lymphocytes, CD8⁺T lymphocytes, Tregs cells and inducible costimulatory molecule (ICOS)⁺ Tregs cells in peripheral blood were compared between those two groups.

Results

After treatment, the APACHEⅡ score [(22.5 ± 2.2) vs. (25.8 ± 1.5), t = 2.025, P = 0.043], IL-6 [(137 ± 33) ng / L vs. (116 ± 42) ng / L, t = 2.785, P = 0.045)], IL-10 [(29 ± 6) ng / L vs. (26 ± 5) ng / L, t = 2.143, P = 0.039], IL-12 [(84 ± 26) ng / L vs. (65 ± 22) ng / L, t = 2.009, P = 0.043], TGF-β [(8.5 ± 2.3) ng / L vs. (9.8 ± 2.8) ng / L, t = 1.613, P = 0.045], CD8⁺T lymphocytes [(43 ± 13)% vs. (38 ± 12)%, t = 1.856, P = 0.043)] and Tregs cells [(5.8 ± 1.1)% vs. (5.1 ± 0.9)%, t = 1.645, P = 0.045] of patients with severe tuberculosis were significantly different between the UTI group and control group. There were no significant differences of IL-2 [(835 ± 188) ng / L vs. (744 ± 324) ng / L, t = 0.656, P = 0.458], INF-γ [(200 ± 88) ng / L vs. (203 ± 78) ng / L, t = 0.912, P = 0.061], TNF-α [(854 ± 256) μg / L vs. (808 ± 213) μg / L, t = 0.956, P = 0.785], CD4⁺T lymphocytes [(48 ± 8)% vs. (49 ± 14)%, t = 0.756, P = 0.985] and ICOS⁺Tregs cells [(1.0 ± 0.7)% vs. (1.0 ± 0.9)%, t = 0.956, P = 0.089] between these two groups.

Conclusion

UTI can regulate the cellular immunity and reduce the release of inflammatory factors in patients with severe tuberculosis, thereby improving their APACHE Ⅱ score and prognosis.

Key words: Urinary trypsin inhibitor, Tuberculosis, Critical illness, Immunomodulation

Minjie Mao, Caihong Wang, Lei Pan, Jiekun Xu, Xiaohong Pan, Junke Qiu, Xiaoqing Huang. Immunomodulatory effect of urinary trypsin inhibitor on patients with severe tuberculosis[J]. Chinese Journal of Critical Care Medicine(Electronic Edition), 2018, 11(06): 372-376.

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Figures/Tables 2

References 20

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组别		例数	IL-2(ng/L)	IL-6(ng/L)	IL-10(ng/L)	IL-12(ng/L)	INF-γ(ng/L)	TGF-β(ng/L)	TNF-α(μg/L)
UTI组		?	?	?	?	?	?	?	?
?	治疗前	42	554 ± 155	457 ± 46	22 ± 9	129 ± 46	154 ± 65	13.4 ± 5.6	646 ± 127
?	治疗后	42	835 ± 188	137 ± 33	29 ± 6	84 ± 26	200 ± 88	8.5 ± 2.3	854 ± 256
对照组		?	?	?	?	?	?	?	?
?	治疗前	42	524 ± 124	478 ± 68	22 ± 4	131 ± 52	148 ± 89	12.8 ± 7.5	689 ± 146
?	治疗后	42	744 ± 324	116 ± 42^a	26 ± 5^a	65 ± 22^a	203 ± 78	9.8 ± 2.8^a	808 ± 213

组别		例数	IL-2(ng/L)	IL-6(ng/L)	IL-10(ng/L)	IL-12(ng/L)	INF-γ(ng/L)	TGF-β(ng/L)	TNF-α(μg/L)
UTI组		?	?	?	?	?	?	?	?
?	治疗前	42	554 ± 155	457 ± 46	22 ± 9	129 ± 46	154 ± 65	13.4 ± 5.6	646 ± 127
?	治疗后	42	835 ± 188	137 ± 33	29 ± 6	84 ± 26	200 ± 88	8.5 ± 2.3	854 ± 256
对照组		?	?	?	?	?	?	?	?
?	治疗前	42	524 ± 124	478 ± 68	22 ± 4	131 ± 52	148 ± 89	12.8 ± 7.5	689 ± 146
?	治疗后	42	744 ± 324	116 ± 42^a	26 ± 5^a	65 ± 22^a	203 ± 78	9.8 ± 2.8^a	808 ± 213

组别		例数	CD4⁺T淋巴细胞	CD8⁺T淋巴细胞	Tregs细胞	ICOS⁺Tregs细胞
UTI组		?	?	?	?	?
?	治疗前	42	44 ± 10	35 ± 12	4.1 ± 1.2	0.9 ± 0.3
?	治疗后	42	48 ± 8	43 ± 13	5.8 ± 1.1	1.0 ± 0.7
对照组		?	?	?	?	?
?	治疗前	42	46 ± 12	35 ± 8	4.3 ± 1.5	0.9 ± 0.5
?	治疗后	42	49 ± 14	38 ± 12^a	5.1 ± 0.9^a	1.0 ± 0.9

组别		例数	CD4⁺T淋巴细胞	CD8⁺T淋巴细胞	Tregs细胞	ICOS⁺Tregs细胞
UTI组		?	?	?	?	?
?	治疗前	42	44 ± 10	35 ± 12	4.1 ± 1.2	0.9 ± 0.3
?	治疗后	42	48 ± 8	43 ± 13	5.8 ± 1.1	1.0 ± 0.7
对照组		?	?	?	?	?
?	治疗前	42	46 ± 12	35 ± 8	4.3 ± 1.5	0.9 ± 0.5
?	治疗后	42	49 ± 14	38 ± 12^a	5.1 ± 0.9^a	1.0 ± 0.9

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