| 摘要: |
| ［摘要］ 目的 分析脓毒症相关急性呼吸窘迫综合征（ARDS）患者外周血单个核细胞（PBMCs）T细胞受体（TCR）信号通路相关因子表达水平。方法 招募2022年3月至2022年11月于广西医科大学第二附属医院接受治疗的脓毒症相关ARDS患者22例作为病例组，于同期招募健康志愿者21名作为对照组。采集研究对象外周静脉血8 mL，分离PBMCs，通过实时荧光定量聚合酶链反应（RT-qPCR）检测TCR信号通路相关因子CD247、T细胞活化连接蛋白（LAT）、白介素-2诱导的T细胞激酶（ITK）的mRNA表达水平。通过酶联免疫吸附试验（ELISA）检测血清白介素-6（IL-6）、白介素-17A（IL-17A）和白介素-10（IL-10）水平。采集病例组支气管肺泡灌洗液（BALF）进行瑞士-吉姆萨染色，观察炎症细胞情况。结果 与对照组相比，病例组PBMCs的CD247、LAT、ITK mRNA表达水平显著降低（P<0.05），血清IL-6、IL-10、IL-17A水平显著升高（P<0.05）。脓毒症ARDS患者BALF中可见中性粒细胞、淋巴细胞、红细胞显著增多，巨噬细胞体积增大；有坏死、脱落的肺泡上皮细胞。结论 脓毒症相关ARDS患者PBMCs的TCR信号通路相关因子表达显著降低，这可能是脓毒症进展的机制之一。 |
| 关键词: 脓毒症 急性呼吸窘迫综合征 T细胞受体信号通路 外周血单个核细胞 |
| DOI：10.3969/j.issn.1674-3806.2025.09.10 |
| 分类号:R 56 |
| 基金项目:国家自然科学基金项目（编号：82360374）；广西重点研发计划项目（编号：桂科AB23026012）；广西医疗卫生适宜技术开发与推广应用项目（编号：S2021063）；广西卫生健康委重点（培育）实验室-广西急危重症医学重点实验室建设项目（编号：ZPZH2020002）；广西卫生健康委员会科研课题（编号：Z20211102） |
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| Analysis on expression levels of factors related to T-cell receptor signaling pathway in peripheral blood mononuclear cells of patients with sepsis-related acute respiratory distress syndrome |
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ZENG Xiaoliang1, YANG Hui1, YANG Yanli2, PENG Liang1, FENG Jihua3, ZHANG Jianfeng4
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1.Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China; 2.Department of Ultrasound, the People′s Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, China; 3.Department of Emergency, the Second Affiliated Hospital of Guangxi Medical University, Nanning 530007, China; 4.Department of Emergency, Wuming Hospital of Guangxi Medical University, Nanning 530199, China
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| Abstract: |
| ［Abstract］ Objective To analyze the expression levels of factors related to T-cell receptor(TCR) signaling pathway in peripheral blood mononuclear cells(PBMCs) of patients with sepsis-related acute respiratory distress syndrome(ARDS). Methods Twenty-two patients with sepsis-related ARDS who were treated in the Second Affiliated Hospital of Guangxi Medical University from March 2022 to November 2022 were recruited as case group, and 21 healthy volunteers were recruited as control group during the same period. A total of 8 mL of peripheral venous blood was collected from each research subjects, and PBMCs were isolated, and the mRNA expression levels of TCR signaling pathway-related factor CD247, linker for activation of T cells(LAT) and interleukin-2-inducible T-cell kinase(ITK) were detected by using real-time fluorescent quantitative polymerase chain reaction(RT-qPCR). The expression levels of serum interleukin-6(IL-6), interleukin-17A(IL-17A) and interleukin-10(IL-10) were detected by using enzyme-linked immunosorbent assay(ELISA). Broncho-alveolar lavage fluid(BALF) was collected from the case group for Swiss-Giemsa staining to observe the inflammatory cells. Results Compared with those in the control group, the expression levels of CD247, LAT and ITK mRNA in PBMCs in the case group were significantly decreased(P<0.05), and the levels of serum IL-6, IL-10 and IL-17A in the case group were significantly increased(P<0.05). In the BALF of the patients with sepsis-related ARDS, significant increases in neutrophils, lymphocytes and red blood cells could be observed, and the volume of macrophages increased, and necrotic and desquamated alveolar epithelial cells were observed. Conclusion Expressions of TCR signaling pathway-related factors in PBMCs of patients with sepsis-related ARDS are significantly decreased, which might be one of the mechanisms of sepsis progression. |
| Key words: Sepsis Acute respiratory distress syndrome(ARDS) T-cell receptor(TCR) signaling pathway Peripheral blood mononuclear cells(PBMCs) |
