Expression and clinical significance of serum interleukin-21 in patients with different types of tuberculosis

doi:10.3877/cma.j.issn.1674-1358.2019.01.010

Abstract

Abstract:

Objective

To investigate the expression level of interleukin 21 (IL-21) and its correlation with tuberculosis antibody in patients with different clinical types of tuberculosis.

Methods

From October 2014 to June 2018, a total of 180 patients with primary tuberculosis in The Sixth Affiliated Hospital of Kunming Medical University were divided into two groups according to the lesion locations: pulmonary tuberculosis group (n = 99, including 37 cases with tuberculous pleurisy) and extrapulmonary tuberculosis group (n = 81); while 140 healthy volunteers were selected as control group. The levels of serum IL-21 and anti-Mycobacterium tuberculosis antibody in the patients with tuberculosis before and after anti-Mycobacterium tuberculosis treatment were detected by Enzyme linked immunosorbent assay (ELISA). IL-21 levels in pleural effusions were detected in patients with tuberculosis pleurisy before treatment. The correlation between serum IL-21 level and anti-Mycobacterium tuberculosis expression was analyzed.

Results

Before anti-Mycobacterium tuberculosis treatment, the serum IL-21 levels in both pulmonary tuberculosis patients [43.16 (72.98) pg/ml] and extrapulmonary tuberculosis patients [38.68 (58.17) pg/ml] were lower than those of healthy controls [59.49 (42.41) pg/ml], with significant differences (Z =-2.788, P = 0.005; Z =-2.788, P = 0.005); but there was no significant difference between pulmonary tuberculosis group and extrapulmonary tuberculosis group (Z = -0.052, P = 0.961). After intensive anti-Mycobacterium tuberculosis treatment, the serum IL-21 levels of both pulmonary tuberculosis and extrapulmonary tuberculosis patients were significantly increased [60.21 (57.58) pg/ml vs. 43.16 (72.98) pg/ml; Z =-2.681, P = 0.007; 66.16 (42.21) pg/ml vs. 38.68 (58.17) pg/ml; Z =-2.422, P = 0.015]. The average level of IL-21 in pleural effusion of patients with tuberculous pleurisy in pulmonary tuberculosis group was significantly higher than their serum IL-21 level before anti-Mycobacterium tuberculosis [121.36 (133.67) pg/ml vs. 49.09 (80.67) pg/ml; Z =-3.477, P = 0.001].

Conclusions

The level of serum IL-21 in patients with active tuberculosis decreased and increased after anti-Mycobacterium tuberculosis, suggesting that the level of IL-21 may be used as an index for observing the effect or clinical outcome of patients with tuberculosis.

Key words: Tuberculosis, Interleukin-21, Cytokines, Mycobacterium tuberculosis, Humoral immunity

Zhibin Yang, Enrui Shen, Li Pan, Lihui Zhao, Cong Wang, Yanxia Yang, Yang Li, Qiaofeng Wang, Shiwu Ma. Expression and clinical significance of serum interleukin-21 in patients with different types of tuberculosis[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2019, 13(01): 48-53.

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References 28

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组别	例数	年龄（±s，岁）	男/女（例）	汉族/其他（例）
健康对照组	140	41.19 ± 15.49	79/61	96/44
肺结核组	99	43.42 ± 15.56	63/36	70/29
肺外结核组	81	42.86 ± 14.67	41/40	49/32
统计值	?	F = 0.721	χ²= 2.206	χ²= 0.151
P值	?	0.452	0.331	0.926
组别	例数	ESR [M（QR），mm/h]		CRP [M（QR），mg/L]
组别	例数	治疗前	治疗后	治疗前	治疗后
健康对照组	140	10.00（6.75）	—	3.32（1.81）	—
肺结核组	99	33.00（36.00）	11.00（7.00）	27.00（56.80）	3.15（2.08）
肺外结核组	81	32.00（40.60）	11.00（5.50）	11.26（35.19）	3.26（1.89）
统计值	?	H = 97.867	H = 1.252^a	H = 105.655	H = 1.558^b
P值	?	0.000	0.535^a	0.000	0.459^b

组别	例数	年龄（±s，岁）	男/女（例）	汉族/其他（例）
健康对照组	140	41.19 ± 15.49	79/61	96/44
肺结核组	99	43.42 ± 15.56	63/36	70/29
肺外结核组	81	42.86 ± 14.67	41/40	49/32
统计值	?	F = 0.721	χ²= 2.206	χ²= 0.151
P值	?	0.452	0.331	0.926
组别	例数	ESR [M（QR），mm/h]		CRP [M（QR），mg/L]
组别	例数	治疗前	治疗后	治疗前	治疗后
健康对照组	140	10.00（6.75）	—	3.32（1.81）	—
肺结核组	99	33.00（36.00）	11.00（7.00）	27.00（56.80）	3.15（2.08）
肺外结核组	81	32.00（40.60）	11.00（5.50）	11.26（35.19）	3.26（1.89）
统计值	?	H = 97.867	H = 1.252^a	H = 105.655	H = 1.558^b
P值	?	0.000	0.535^a	0.000	0.459^b

组别		例数	血清IL-21水平	Z值	P值
治疗前		?	?	?	?
?	健康对照组	140	59.49（42.41）	－2.788^a	0.005^a
?	肺结核组	99	43.16（72.98）	－0.052^b	0.961^b
?	肺外结核组	81	38.68（58.17）	－2.364^c	0.016^c
H值		?	10.296	?	?
P值		?	0.006	?	?
治疗后		?	?	?	?
?	健康对照组	140	59.49（42.41）	－0.542^e	0.588^e
?	肺结核组	99	60.21（57.58）	－0.822^f	0.413^f
?	肺外结核组	81	66.16（42.21）	－1.118^g	0.262^g
H值		?	1.396	?	?
P值		?	0.498	?	?

组别		例数	血清IL-21水平	Z值	P值
治疗前		?	?	?	?
?	健康对照组	140	59.49（42.41）	－2.788^a	0.005^a
?	肺结核组	99	43.16（72.98）	－0.052^b	0.961^b
?	肺外结核组	81	38.68（58.17）	－2.364^c	0.016^c
H值		?	10.296	?	?
P值		?	0.006	?	?
治疗后		?	?	?	?
?	健康对照组	140	59.49（42.41）	－0.542^e	0.588^e
?	肺结核组	99	60.21（57.58）	－0.822^f	0.413^f
?	肺外结核组	81	66.16（42.21）	－1.118^g	0.262^g
H值		?	1.396	?	?
P值		?	0.498	?	?

组别		例数	IL-21水平	Z值	P值
健康对照组		140	59.49（42.41）	－4.031^a	<0.001^a
结核性胸膜炎		37	?	?	?
?	胸水	?	121.36（133.67）	－0.045^b	0.608^b
?	血清	?	49.09（80.67）	－3.477^c	0.001^c
H值		?	19.81	?	?
P值		?	0.001	?	?

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