Preliminary Study On The Relationship Between The Expression Of Signal-regulated Protein Alpha And Tuberculosis And Acute Liver Damage

Tuberculosis is a highly contagious disease that is seriously harmful to human health.In recent years,due to multiple drug-resistant tuberculosis,a large number of cases of tuberculosis and HIV infection have caused a rapid increase in the incidence of tuberculosis,which seriously endangers human health.Signal regulatory protein a(SIRPa)is a multi-transmembrane protein.Previous studies have demonstrated that SIRPa is involved in a variety of biological processes,including macrophage polynuclear,skeletal muscle differentiation,neuronal survival,and diabetes.Protection and negative regulation of immune cells.At present,the relationship between the expression of SIRPa and the pathogenesis of tuberculosis is still unclear.This study focuses on the expression of SIRPa in tuberculosis and the correlation between the expression of SIRPa and the changes in liver function of tuberculosis during the initial anti-tuberculosis treatment.Objective(1)To study the expression of SIRPa in healthy people and the expression of newly diagnosed TB patients;(2)Explore the differences between the SIRPa high expression group and the SIRPa low expression group in tuberculosis patients;(3)To analyze the correlation between the expression of SIRPa and the changes of tuberculosis liver function indexes(AST,ALT,albumin)during the initial anti-tuberculosis treatment.MethodsA total of 109 whole blood samples from patients with pulmonary tuberculosis from December 2017 to September 1818 were collected as experimental groups,namely 74 specimens from Beijing 309 Hospital and 35 specimens from Shenyang Chest Hospital.A total of 35 whole blood samples from the Beijing 309 Hospital Health Check were collected as a control group.Flow cytometry was used to detect the expression of SIRPa in tuberculosis patients and control groups.Patients in the tuberculosis group were divided into SIRPa high expression group and SIRPa according to the level of SIRPa expression(average fluorescence intensity detected by flow cytometry).The expression group,as well as the expression of alanine aminotransferase(ALT)and aspartate aminotransferase(AST)after one week of isoniazid rifampicin combined with anti-tuberculosis treatment in the patients with newly diagnosed pulmonary tuberculosis.In addition,the correlation between SIRPa expression and liver damage during initial anti-tuberculosis treatment was analyzed.Results(1)By using flow cytometry for quantitative analysis,SIRPa is lowly expressed in healthy subjects and highly expressed in patients in the tuberculosis group.(2)According to the results of SIRPa detected by flow cytometry,34 patients with pulmonary tuberculosis in Shenyang Chest Hospital were divided into SIRPa high expression group(the average fluorescence intensity of SIRPa was greater than or equal to 4000,17 cases)and SIRPa low expression group.(The average fluorescence intensity of SIRPa is less than 4000,17 cases).Because most of the 74 patients with pulmonary tuberculosis in Beijing 309 Hospital are mainly anti-tuberculosis treatment,some of them are not detected liver function or discharged earlier,so the two groups of liver function after anti-tuberculosis treatment The change of index is difficult to achieve,so the results of 74 patients with pulmonary tuberculosis can not be used when liver function is treated one week later.The specimens of a tuberculosis patient in Shenyang Chest Hospital were unqualified and discarded.As shown in Table 2 of Table 1,there was no significant difference in tuberculosis patients with SIRPa high expression group and tuberculosis patients with SIRPa low expression group in terms of number,gender,age,invasive tuberculosis,and liver damage indicators ALT and AST at admission(P>0.05),and the tuberculosis patients with SIRPa high expression group and the SIRPa low expression group had no significant difference in ALT expression between the two groups after one week of initial anti-tuberculosis treatment,while there was significant difference in AST expression..As shown in Table 4 in Table 3,when the SIRPa was lowly expressed in the tuberculosis group,the ALT and AST after one week of initial anti-tuberculosis treatment were higher than those at the time of admission.When the SIRPa was highly expressed in the tuberculosis group,the ALT after one week of initial anti-tuberculosis treatment.The AST was lower than that at admission,but both were within the normal range,and the difference was not statistically significant.Conclusions(1)SIRPa is lowly expressed in healthy people,and is highly expressed in tuberculosis group,suggesting that SIRPa expression is closely related to the occurrence of tuberculosis.(2)Dynamic monitoring of the degree of liver damage in the anti-tuberculosis treatment of SIRPa high expression group and low expression group in patients with newly diagnosed pulmonary tuberculosis has not been reported at home and abroad.At the time of admission,there was no significant difference in liver damage between the two groups of pulmonary tuberculosis patients.After one week of treatment with rifampicin and isoniazid combined with anti-tuberculosis treatment,there was no difference in ALT between the two groups.The reason may be that the follow-up time was shorter.In patients with tuberculosis,the liver damage was the earliest one week after the 2HRZE routine treatment.Some experiments showed that the drug-induced liver injury rate caused by anti-tuberculosis treatment was 8.87%,88%of which occurred at the beginning of the treatment.During the month,12%occurred in the 4th to 5th months.In this experiment,one week after the initial anti-tuberculosis treatment in the tuberculosis group,there was a significant difference between the SIRPa high expression group and the low expression group in AST.The SIRPa low expression group had a higher AST elevation than the SIRPa high expression group,indicating that the SIRPa low expression group Liver damage occurs relatively early,the relevant mechanism is the increase of inflammatory factor secretion caused by low expression of SIRPa,which causes the degree of liver damage to increase,so the expression of AST increases,but the specific mechanism has not been clarified.When SIRPa was low in the tuberculosis group,the expression of ALT and AST after one week of initial anti-tuberculosis treatment was higher than that at admission.When SIRPa was highly expressed in the tuberculosis group,the expression of ALT and AST after one week of initial anti-tuberculosis treatment was lower than that at admission.However,they are all within the normal reference range and the difference is not statistically significant.It is proved that the level of SIRPa expression in patients with newly diagnosed pulmonary tuberculosis may be negatively correlated with the changes of liver damage during anti-tuberculosis treatment.The specific mechanism is not clear,and the number of cases is lacking and the observation time is relatively limited.And extend the observation time to ensure the accuracy of the conclusion.