Objective: One of the primary reasons for the successful patriotization of Echinococcus multilocularis in patients is its ability to induce host immune tolerance. This study examined the expression of the immunosuppressive Tim-3/Galectin-9 pathway, CD8+T cells, and related factors in AE patients. The aim was to analyze the relationship between the Tim-3/Galectin-9 pathway and CD8+T cells in this disease and further understand the mechanism of immune tolerance induced by cystic echinococcosis. Methods: Using flow cytometry, we evaluated the expression of CTL, CD8(+)CD28-T cells, CD8(+)CD28 + IFN-gamma + T cells, CD8(+)CD28+perforin + T cells, CD8(+)CD28+granzyme B + T cells, CD8(+)CD28-IL-10 + T cells, CD8(+)CD28-TGF-beta+T cells, and Tim-3 expression on CD8+T cells in the peripheral blood of control (n = 30) and AE patients (n = 33). qRT-PCR was used to measure CD107a and Tim-3/Galectin-9 mRNA levels in PBMCs from the control and AE groups. Immunohistochemistry was employed to detect IL-10, TGF-beta, and Tim-3/Galectin-9 expressions in the infected livers of AE patients. Results: AE patients exhibited a significant decrease in peripheral blood CTL ratio (P < 0.001) and an increase in CD8(+)CD28+IFN-gamma+T cell ratio (P < 0.001). No significant changes were observed in the ratios of CD8(+)CD28+perforin + T cells (P = 0.720) and CD8(+)CD28+granzyme B + T cells (P = 0.051). The proportions of CD8(+)CD28-T cells (P < 0.001), CD8(+)CD28-IL-10 + T cells (P < 0.001), and CD8(+)CD28-TGF-beta+T cells (P < 0.001) were notably higher than in the control group. The expression of Tim-3 on CTL and CD8(+)CD28-T cells in AE patients was significantly upregulated (P < 0.001, P < 0.001). AE patients displayed a substantial decrease in peripheral blood PBMC CD107a mRNA levels (P < 0.001) and significant elevations in Tim-3/Galectin-9 mRNA levels (P < 0.001, P < 0.001). A negative correlation was observed between CD107a mRNA levels and both Tim-3 (r<^>2 = 0.411, P < 0.001) and Galectin-9 (r(2) = 0.180, P = 0.019) mRNA levels. Expressions of IL-10 (P < 0.001), TGF-beta (P < 0.001), and Tim-3/Galectin-9 (P < 0.001, P < 0.001) in AE patient-infected livers were significantly higher than in uninfected regions. IL-10 and TGF-beta expressions showed a positive correlation with Tim-3/Galectin-9. Conclusion" This study suggests that the high expression of Tim-3 on CD8+T cell surfaces in AE patients might promote an increase in CD8(+)CD28-T cells and related factors, while suppressing CTL and related factor expressions. This potentially induces the onset of immune tolerance, which is unfavorable for the clearance of Echinococcus multilocularis in patients, leading to the exacerbation of persistent infections.

Expression of Tim-3/Galectin-9 Pathway and CD8+T Cells and Related Factors in Patients with Cystic Echinococcosis.