[Dynamic analysis of tuberculosis specific mononuclear cells in peripheral blood of HIV patients with tuberculosis].

Objective: To evaluate the response of peripheral blood mononuclear cells (PBMCs) in patients with human immunodeficiency virus (HIV) combined with active tuberculosis (TB) to TB-specific antigen stimulation. Methods: From January to December, 2018, individuals infected with both HIV and TB (HIV/TB group) were taken as the study subjects. Individuals infected with HIV alone (HIV group), individuals infected with TB alone (TB group) and healthy people (Health control group, HC group) were taken as the control groups. PBMCs were isolated and stimulated with purified protein derivative of bacillus calmette-guerin (BCG-PPD). The expression of surface molecules in T cells (CD3+, CD4+, CD8+) and monocytes (CD14+) and the percentages of Interferon (IFN)-γ and tumor necrosis factor (TNF)-α were detected by cell surface molecular staining, direct intracellular cytokine staining and flow cytometry (CD3- lymphocytes were mainly B lymphocytes and NK cells). Analysis of non-parametric data was used to compare the data between the two groups, and paired t-test was used to compare the data before and after PPD stimulation in each group. Results: Before PPD stimulation, the percentage of IFN-γ+ CD8+ cells in the peripheral blood of HIV/TB group(mean 0.52%) was significantly lower than that in TB group(mean 0.94%, P=0.010). The TNF-α+cell percentages in CD3+, CD4+, CD8+, or CD14+ cells in the HIV/TB group(mean 19.2%) were significantly lower than those in the HIV group(mean 31.9%, P=0.002). The percentage of TNF-α secreted by monocytes in the HIV group was significantly lower than that in the HC group. The percentages of IFN-γ+ CD8+ and IFN-γ+ CD3- cells in the peripheral blood of the TB group (mean 0.94%) were significantly higher than thoset in the HC group(mean 0.51%, P=0.020), while the percentages of TNF-α+ cells in each subsets of PBMCs were significantly lower than those in the HC group. After PPD stimulation, the percentage of IFN-γ+ CD8+ cells in the HIV/TB group was significantly lower than that in the TB group(P=0.008), and the change was more marked than that before stimulation. The percentage of IFN-γ+ CD8+ cells in the HIV group(mean 0.20%) was lower than that in the HC group (mean 0.52%, P=0.044). The percentage of IFN-γ+ CD3- in the TB group was significantly higher than in the HC group. There were no significant differences in TNF-α+ cell percentages in the 3 groups compared with the control group after PPD stimulation. The percentages of IFN-γ+ CD4+ cells in the HC and the TB groups were significantly increased after PPD stimulation in each group (P=0.002, P=0.001, respectively). However, there were no significant differences of IFN-γ+ CD4+ cell percentages in the HIV/TB group and the HIV group. The percentages of TNF-α production by monocytes were significantly increased after PPD stimulation in all groups. Conclusions: Chronic Mycobacterium tuberculosis (MTB) infection reduced the ability of PBMCs to produce TNF-α. For patients with TB infection, the production of TNF-α was reduced when combined with HIV infection. The capacity of CD8+ and CD3- lymphocytes to produce IFN-γ was increased in TB patients, while the capacity of CD8+ T cells to produce IFN-γ was decreased with co-infection of HIV. Infection of HIV weakened the immune response to MTB infection, which made the clinical diagnosis and treatment of TB more difficult.

Research on the expression of MRNA-518b in the pathogenesis of placenta accreta.

OBJECTIVE: To investigate the expression of micro ribonucleic acid miR-518b and its regulatory role in the pathogenesis of placenta accreta. PATIENTS AND METHODS: A total of 50 parturient women in the Obstetric Department were collected and divided into observation group (placenta accreta, n=23) and control group (normal placenta, n=27). After the placental tissues were removed via surgery, the expressions of osteopontin (OPN) and vascular endothelial growth factor (VEGF) were detected using the immunohistochemical method. The relative expression levels of OPN and VEGF proteins were detected via Western blotting, and the relative expression levels of OPN messenger RNA (mRNA), VEGF mRNA and miR-518b were detected via quantitative polymerase chain reaction (qPCR). Moreover, the correlations of miR-518b with OPN mRNA and VEGF mRNA were studied via Pearson correlation analysis. RESULTS: Compared with those in control group, the expressions of OPN and VEGF proteins in observation group were significantly increased, while the levels of OPN mRNA, VEGF mRNA and miR-518b in observation group were also significantly elevated (p<0.05). There were positive correlations between miR-518b and levels of OPN, VEGF mRNA. CONCLUSIONS: The high expression of miR-518b may lead to the development of placenta accreta through upregulating the transcription and protein expression of downstream VEGF and OPN, providing insights for the future therapy against the pathogenesis of placenta accreta.