结核病免疫治疗的研究进展

doi:10.19982/j.issn.1000-6621.20220194

摘要/Abstract

摘要：

目前结核病临床治疗面临众多挑战,特别是耐多药结核病。免疫治疗可以提高机体对结核分枝杆菌感染的保护性免疫应答,是常规化学药物治疗的重要辅助。本文总结了有潜力用于结核病免疫治疗的细胞因子、免疫细胞以及免疫调节药物的研究进展,并分析了其临床应用前景,旨在为结核病的临床研究和机制探索提供思路。

关键词: 结核, 免疫, 综述文献(主题)

Abstract:

At present, the treatment of tuberculosis, especially multidrug-resistant tuberculosis (MDR-TB) faces many challenges. Immunotherapy can improve the protective immunological response to Mycobacterium tuberculosis infection, thus is an important beneficial supplement to conventional chemotherapy. In this paper, we summarize the research progress of cytokines, immunological cells and immunomodulatory drugs that have the potential to be used in the immunotherapy of tuberculosis and analyze their clinical application prospects, to provide ideas for future clinical researches and mechanism exploration of tuberculosis.

Key words: Tuberculosis, Immunity, Review literature as topic

中图分类号:

R52
Q939.91

王丽, 杨恩卓, 沙巍, 沈洪波. 结核病免疫治疗的研究进展[J]. 中国防痨杂志, 2022, 44(10): 1079-1084. doi: 10.19982/j.issn.1000-6621.20220194

Wang Li, Yang Enzhuo, Sha Wei, Shen Hongbo. Research progress in immunotherapy of tuberculosis[J]. Chinese Journal of Antituberculosis, 2022, 44(10): 1079-1084. doi: 10.19982/j.issn.1000-6621.20220194

图/表 2

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表2

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细胞因子	作用机制	主要效果
γ-干扰素	激活巨噬细胞、增强抗原加工和呈递、驱动细胞免疫等	缓解并稳定病情
粒细胞-巨噬细胞集落刺激因子	减少MTB胞内生长	降低菌落数,提高一线抗结核药物疗效
白细胞介素1	调节固有免疫和获得性免疫,增强抗MTB免疫	抑制MTB增殖
白细胞介素2	促进T细胞增殖	加快痰涂片阴转,改善肺部病变

免疫细胞	治疗方式	作用机制	主要效果
Vγ2Vδ2T细胞	体外扩增回输或者体内刺激γδT细胞增殖	识别MTB和宿主细胞的磷酸抗原	抗感染
固有自然杀伤T细胞	固有自然杀伤T细胞移植	释放大量IFN-γ进一步激活巨噬细胞,分泌粒细胞-巨噬细胞集落刺激因子	抑制MTB的增殖
黏膜相关固有T细胞	5-OP-RU疫苗刺激	分泌IFN-γ、TNF-α,启动CD4⁺T 细胞,减少靶器官MTB菌落数	早期感染控制
调节性T细胞	抑制调节性T细胞增殖和活性	干扰树突状细胞对T细胞的激活,抑制Th1和Th17介导的免疫反应	提高免疫应答水平
细胞因子诱导的杀伤细胞	体外扩增和活化淋巴细胞后回输	具有T淋巴细胞强大的免疫活性和NK细胞的非主要组织相容性复合体限制的优点	提高MDR-TB的疗效