Characteristics of patients with bone joint brucellosis and analysis of changes in inflammation and immune indicators before and after antibacterial treatment

CHEN Handong; GU Zhiyong; ZHANG Xiaolei; GAO Zhan; DING Feixue; WU Lihai; YANG Limin; MIAO Liang

doi:10.3969/j.issn.1007-8134.2025.05.008

Abstract：Objective To analyze the clinical characteristics of patients with osteoarticular brucellosis and to investigate the effects of antimicrobial therapy on inflammation and immune indicators.Methods A total of 63 patients diagnosed with osteoarticular brucellosis(study group)and 70 patients with non-osteaoarticular brucellosis(control group)admitted to the Department of Infection Diseases,Qinhuangdao Third Hospital from January 2020 to June 2023 were included.The clinical symptoms,levels of acute-phase inflammatory cytokines,and percentages and ratios of peripheral blood T lymphocyte subsets were compared between the 2 groups.Changes in these indicators before and after antibacterial therapy in the study group were analyzed.Results There were no significant differences in the incidence of splenomegaly,hepatomegaly,fatigue,fever,sweating,lymphadenopathy or neurological,digestive and reproductive systems symptoms between the 2 groups(P>0.05).Serum levels of tumor necrosis factor(TNF-α)and interleukin-6(IL-6)were significantly higher in the study group than those in the control group,while interleukin-4(IL-4)levels were lower(P<0.05).No significant differences were observed in interferon-γ(IFN-γ),interleukin-17(IL-17),or interleukin-10(IL-10)levels between the 2 groups(P>0.05).The percentages of CD4+T cells and Th1 cells,as well as of CD4+/CD8+ratio,were significantly higher in the study group than in the control group(P<0.05).There were no significant differences in CD8+T cells,Th2 cell percentages,or the of Th1/Th2 ratio between the two groups(P>0.05).After antibacterial treatment,levels of IFN-γ,TNF-α,IL-6,IL-17,and IL-10 decreased significantly,while IL-4 levels increased significantly compared to pre-treatment levels(P<0.05).Additionally,the percentages of CD4+T cells and Th1 cells,as well as the CD4+/CD8+and Th1/Th2 ratios,decreased significantly after treatment,while the percentage of CD8+T cells increased(all P<0.05).Conclusion Patients with osteoarticular brucellosis show similar clinical features to those with non-osteoarticular brucellosis patients.However,osteoarticular brucellosis is associated with stronger inflammatory response and elevated peripheral blood lymphocyte subset expression.Antimicrobial therapy significantly alleviates the inflammatory response and reduces peripheral blood lymphocyte levels.