COPD Co-infection With Tuberculosis on Th17 Cell Differentiation

Study Overview
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Brief Summary
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This project will observe and follow up the changes of pulmonary function and CT in patients with smoking combined with pulmonary tuberculosis, and measure the ratio of Th1 cells, Th17 cells, macrophages and neutrophils and the secretion of factors such as TNF-α, IFN-γ and IL-17 in pulmonary blood and alveolar lavage fluid.

Detailed Description
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Chronic obstructive pulmonary disease (COPD) and tuberculosis are major global health problems, and acquired and acquired immunity play an important role in COPD and tuberculosis, and there is an interaction between COPD and tuberculosis, but the exact mechanism is not clear. Pre-existing TB infection is an independent risk factor for COPD and can aggravate pulmonary function and increase hospitalization and mortality in COPD patients. In COPD patients, Th1 and Th17 cells are involved in the development of COPD and emphysema through activation of macrophages and recruitment of neutrophils, while matrix metalloproteinases (MMPs) of macrophage and neutrophil origin are involved in the formation of tuberculosis cavities, and cytokines such as TNF-α, IFN-γ, IL-17 are involved in the mechanism of their destruction, IL-17 restricts the expression of HIF-1α to inhibit the development of TB granulomas, and CT analysis revealed that combined TB exacerbates emphysema in COPD patients. The above evidence suggests that tuberculosis plays an important role in the formation of emphysema in COPD. In this project, we will observe and follow up the changes of pulmonary function and CT in patients with smoking combined with pulmonary tuberculosis, and examine the ratio of Th1 cells, Th17 cells, macrophages and neutrophils and the secretion of TNF-α, IFN-γ, and IL-17 in pulmonary blood and alveolar lavage fluid.

Official Title
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Effect of COPD Co-infection With Tuberculosis on Th17 Cell Differentiation and Its Significance

Conditions
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Tuberculosis Infection, Chronic Obstructive Pulmonary Disease

Intervention / Treatment
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* Other: No intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Clinical diagnosis of COPD age ≧ 40 Exclusion Criteria: Presence of other chronic respiratory diseases other than COPD, such as asthma, bronchiectasis, interstitial lung disease, etc. History of chest and lung surgery. History of malignancy. Autoimmune disease. Long-term oral glucocorticoids, immunosuppressants and inhaled glucocorticoids. Mental abnormalities, cognitive impairment, inability to cooperate with pulmonary function and other tests. Acute stage of infection, such as lung infection, urinary tract infection and gastrointestinal tract infection, etc.

Ages Eligible for Study
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Minimum Age: 40 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| COPD combined with TB group<br>COPD combined with pulmonary TB infection | Other: No intervention<br>* No intervention<br>|
| COPD non-TB control group<br>COPD combined without pulmonary TB infection | |
| TB non-COPD control group<br>pulmonary TB infection without COPD | |
| Non-smoking non-TB control group<br>Non-smoking without pulmonary TB infection | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Differentiation of Th17 cells | Distribution of T cell subtypes, including CD4+, CD8+ T cells and Th17 cells, in blood specimens and alveolar lavage fluid by flow cytometry | Day 1 |