The Expressions Of ??T And Other Lymphocytes In Patients With Acute And Subacute Brucellosis

Object:To observe levels of immune activation of ??T cells, CD4~+ and CD8~+T cells in acute and subacute brucellosis before and after 6 weeks antimicrobial treatment and discuss differences of expression levels and changes of cell counts before and after treatment between different stages of brucellosis; and further analysis levels of immune activation of ??T cells?CD4~+ and CD8~+T cells in different periods of brucellosis providing theory basis for immune therapy. Methods:194 cases hospitalized in The second people's Hospital of Tianjin with brucellosis between August 2008 and August 2015 were enrolled, with 155 acute brucellosis cases, and 39 subacute brucellosis cases.All of the patients' treatment were according to the "practical epidemiology(3rd edition)" antimicrobial treatment standards.The antibacterial therapy was 6 weeks.Take peripheral blood before treatment and 6 weeks after treatment in patients and use BD FACSCalibur flow cytometry to detect all patients' ??T cells, CD4~+ and CD8~+ T cells count.And choose 30 healthy hospital staff as healthy controls.Compare immune status of ??T cells, CD4~+ and CD8~+ T cells of acute and subacute brucellosis and health controls before treatment.Analysis changes of these cells in acute and subacute brucellosis before and after treatment,and compare acute and subacute brucellosis and health controls of ??T cells? CD4~+ and CD8~+ T cells of immune status after treatment. Results: 1.The median of ??T cells?CD4~+ and CD8~+T cells counts of acute brucellosis patients before treatment were 92.0/?l?764.0/ ?l and 770.0/?l,and in subacute patients were 76.0/?l?857.0 /?l and 708.0 /?l, and in healthy controls were 27.5/?l, 622/?l and 442.5/?l. ??T cells?CD4~+T cells and CD8~+ T cells counts of acute brucellosis were significantly higher than healthy controls(P<0.01). ??T cells?CD4~+ T cells and CD8~+ T cells(P<0.01) counts of subacute brucellosis increased significantly compared with healthy controls. The counts of CD4~+ T cells of subacute brucellosis patients were significantly higher than acute patients(P<0.01). 2. Cases that complete 6 weeks treatment included 31 patients with acute phase, 30 patients with subacute stage. The differences of ??T cells [106(97,142)/?l vs 70(41,130)/?l, P=0.002), CD4~+ T cells [828(784,868/?l vs 704(595,847)/?l, P=0.001), and CD8~+ T cells [822(696,936)/?l vs 695(620,772)/?l, P=0.001] of acute brucellosis before and after treatment were statistically significant, and were significantly reduced after treatment. The differences of ??T cells [86(68,125)/?l vs 43(27,75)/?l, P=0.000)], CD4~+ T cells[914(830,1046)/?l vs 799(533,829)/?l, P=0.000)] and CD8~+ T cells [842(521,101)/?l vs 599(549,745)/?l, P=0.022)] of subacute patients before and after treatment were statistically significant,and were significantly reduced after treatment. ??T cells, CD4~+T cells, and CD8~+T cells of acute patients after treatment were significantly higher than healthy controls(respectively,P=0.000,P=0.000,P=0.021). ??T cells, CD4~+T cells, and CD8~+T cells of subacute brucellosis patients after treatment were significantly higher than healthy controls(respectively,P=0.007,P=0.030,P=0.000). ??T cells of acute group were significantly higher than subacute group(P<0.05). Conclusion: 1.The ??T cells?CD4~+ and CD8~+T cells of acute and subacute brucellosis patients before treatment were immune activation significantly higher than healthy people and degrees of activation are highly correlated with disease progression. The CD4~+ T cells in untreated subacute brucellosis patients are higher than acute patients. 2.After 6 weeks treatment, ??T cells?CD4~+ and CD8~+T cells of acute and subacute brucellosis were significantly reduced, but still higher than healthy people.After treatment, ??T cells in different periods of brucellosis are different, acute brucellosis were higher than subacute brucellosis.Determination of changes of these activated cells contributes to understanding of acute and subacute brucellosis immune status, providing theory basis for immune therapy.