Study On Immune Cells And Cytokines In Anti-tuberculosis Drug-Induced Liver Injury

Objective:To analyze the relationship between the ratio of CD3~+T cells,CD4~+T cells,CD8~+T cells,CD4~+/CD8~+,B lymphocytes,NK cells,Th17 cells,Treg cells,CD4~+IFN-γ~+T,CD4~+TNF-α~+T,CD8~+IFN-γ~+T,CD8~+TNF-α~+T and intercellular ratio and IFN-γ,TNF-α,IL-10 cytokines in the process of anti-tuberculosis drug induced liver injury(ATDILI),so as to provide a basis for the elucidation of the precise mechanisms by which ATDILI.Methods:Patients diagnosed with newly diagnosed pulmonary tuberculosis in the inpatient and outpatient departments of the First Affiliated Hospital of Shihezi University Medical College from January 2021 to January 2022 were included.The patients with anti-tuberculosis drug-induced liver injury(ATDILI)within2 months were selected as the observation group,and the patients with pulmonary tuberculosis who completed the whole 2-month intensive anti-tuberculosis process without liver injury were selected as the control group.There were 23 cases in observation group and 22 cases in control group.His system in our hospital was used to collect the general data and biochemical index data before treatment.The biochemical data of liver injury in ATDILI group were collected after 2 months of anti-tuberlosis treatment in control group.The peripheral blood immune cell levels of all patients were tested before treatment,during drug-induced liver injury in the observation group,and 2 months after anti-tuberculosis treatment in the control group were measured by flow cytometry and ELISA.Using SPSS26.0 statistical software,using t test,chi-square test statistical methods for analysis,P<0.05 was considered statistically significant.Results:(1)Before anti-tuberculosis treatment,there was no statistical difference in the basic data and biochemical indicators(including gender,age,height,weight,body mass index(BMI),ALT,AST,GGT,ALP,Tbil,white blood cell count,neutrophil count,lymphocyte count)between the observation and control groups(P>0.05).(2)There was no significant difference between observation group and control group before anti-tuberculosis treatment in peripheral blood%CD3~+T lymphocytes,%CD4~+T lymphocytes,%CD8~+T lymphocytes,CD4~+/CD8~+,%B lymphocytes,%NK cells,%Th17 cells,%Treg cells,Th17/Treg,%CD4~+IFN-γ~+T lymphocytes,%CD4~+TNF-α~+T lymphocytes,CD8~+IFN-γ~+T lymphocytes,%CD8~+TNF-α~+T lymphocytes,IFN-γ,TNF-α,IL-10 cytokine(P>0.05).(3)After anti-tuberculosis treatment,in the observation group,compared with the control group,%CD8~+T lymphocytes,CD4~+/CD8~+ratio,%NK lymphocyte frequency,%Th17 lymphocytes,%Treg lymphocytes,%CD8~+IFN-γ~+T cells,%CD8~+TNF-α~+T cells,IFN-γ,TNF-α,IL-10 cytokine levels were significantly higher than the control group,the difference was statistically significant(P<0.05).(4)After anti-tuberculosis treatment,there was no significant difference in%CD3~+T lymphocytes,%CD4~+T lymphocytes,%B cells,%CD4~+IFN-γ~+T lymphocytes,%CD4~+TNF-α~+T cells between the patients in the observation group and the control group(P>0.05).Conclusion:The level of CD8~+T,NK cells,Th17 cells,Treg cells,CD8~+IFN-γ~+T cells,CD8~+TNF-α~+T cells and IFN-γ,TNF-α,IL-10 cytokines in patients with ATDILI were higher than those in patients without ATDILI after anti-tuberculosis treatment,indicating perhaps that the imbalance of lymphocytes,cytokines and cell ratio was involved in the occurrence and development of ATDILI.