The impact of different anti tuberculosis treatment effects on the gut microbiota and immune status of patients
Objective To study the gut microbiota and immune function of tuberculosis patients with different treatment effects,and further explore whether there were differences in microbiota and immune indicators among tuberculosis patients with different treatment effects.Methods A total of 107 patients with tuberculosis after initial treatment in the Changsha Central Hospital from January 2020 to February 2021 were collected and divided into poor efficacy group(n=32)and good efficacy group(n=75)by consulting inpatient medical records and using face-to-face questionnaire interview registration results.Patient and blood samples were collected,and the diversity of intestinal flora and immune function between different groups were compared by high-throughput sequencing,bioinformatics,flow cytometry,ELISA and tuberculosis susceptibility.Results Compared with the poor efficacy group,IFN-γ and CD4+％of the good efficacy group were increased,and TNF-α levels were decreased;the differences were statistically significant(t=2.222,2.377,2.104;all P＜0.05),while there was no statistical significance(P＞0.05)in IL-4,11-10,CD3+％and CD4+/CD8+.From the perspective of order,family,and genus,the differences were statistically significant(U=983,983,982;all P＜0.05)between unclassified erysipelas and other bacteria(P＞0.05).From the results of bacterial metabolism and phenotype prediction,there were significant differences(Z=0.999,0.999,0.999,0.999;all P＜0.05)between the two groups in bacterial metabolic functions such as non-homologous end connections,caffeine metabolism,indole alkaloid synthesis,and steroid synthesis;there were significant differences(Z=0.179,0.179,0.179,0.179,0.179;all P＜0.05)in aerobic bacterial heterotrophic,host symbiosis,aromatic compound degradation,hydrocarbon degradation,and nitrate reduction functions.In terms of drug-resistant bacteria,the difference was statistically significant(x2=8.698,P＜0.05)between the two groups in multidrug-resistant Mycobacterium tuberculosis.Conclusions It had been preliminarily confirmed that tuberculosis patients with poor treatment effects had more severe damage to their immune function than those with good treatment effect.It was found that there was a significant difference in the unclassified genus of Erysipella between the two groups,might suggesting that it could be one of the important factors affecting the poor treatment effect of pulmonary tuberculosis patients.The metabolic dysfunction of gut microbiota,disruption of gut microbiota,and infection with multidrug-resistant mycobacterium tuberculosis might have an impact on the final therapeutic effect.
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