The changes of the ratio of T helper 17 and regulatory T cells in the peripheral blood of patients with anti-tuberculosis drug-induced liver injury and its significance

Abstract

Objective To observe the changes of the peripheral blood T helper (Th)17 cells/regulatory T cells (Treg) ratio in patients with anti-tuberculosis drug-induced liver injury, and to explore the relationship between Th17/Treg ratio and liver function. Methods Ninety inpatients with the diagnosis of secondary pulmonary tuberculosis (TB) from Affiliated Hospital of Zunyi Medical College from Feb. 2013 to Mar. 2015 were included in this study. All these patients had normal base line liver function. After 2 weeks of anti-TB chemotherapy, 21 patients with alanine transaminase (ALT) and/or aspartate aminotransferase (AST) ≥2×upper limit of normal (ULN) were defined as TB with liver injure group, the other 69 patients with ALT and/or AST<2×ULN were defined as TB with non-liver injured group. Before treatment and two weeks after anti-TB therapy, the peripheral blood Th17/Treg ratios and liver functions of all patients in both groups were detected in order to compare the changes of Th17/Treg ratios pre and post anti-TB chemotherapy and to explore the relationship between Th17/Treg ratio and ALT/AST levels. Student's t test was used for statistical analysis, and Pearson correlation analysis was used for correlation test. Results Before treatment, there was no statistical significance of Th17, Treg and Th17/Treg ratio between groups (P>0.05). The Th17 levels in TB with liver injured group ([2.522±0.388]/mL vs [2.075±0.369]/mL, t=3.633, P 0.05). The Th17 level and Th17/Treg ratio in TB with liver injured group were significantly higher than those in TB with non-liver injured group (t=2.203, P 0.05). Conclusion The changes of Th17/Treg ratio are related with anti-TB drug-induced liver injury in patients with secondary pulmonary tuberculosis. Key words: Tuberculosis, pulmonary; Drug-induced liver injury; Antitubercular; Th17/Treg