摘要
目的 探讨艾滋病患者抗反转录病毒治疗（ART）后外周血Th22、Th17、Th1和Treg的变化及其意义.方法 通过流式细胞仪检测40例艾滋病患者ART前及治疗后3个月外周血Th22、Th17、Th1、Treg表达情况.同时选取30名健康人作为对照.组间比较先行方差齐性检验,再行配对t检验,相关性分析采用Spearman rank检验.结果 治疗前艾滋病患者外周血Th22、Th17和Th1均低于健康对照者,分别为（0.59±0.47）％比（1.65±0.56）％ （t=8.544,P＜0.01）、（4.46±1.84）％比（6.98±1.86）％（t=5.619,P＜0.01）和（16.75±6.72）％比（22.77±6.87）％（t=5.311,P＜0.01）.治疗3个月后,Th22、Th17分别为（1.60±1.10）％（t=5.268,P＜0.01）和（6.33±2.64）％（t=3.663,P＜0.01）,与治疗前比较差异有统计学意义,与健康对照者比较,差异无统计学意义（t值分别为1.783、1.143,均P＞0.05）;而Th1治疗前后无显著变化,仍低于健康对照者.治疗前艾滋病患者外周血Treg高于健康对照者,为（10.76±3.76）％比（7.01±1.88）％,差异有统计学意义（t=5.003,P＜0.01）;治疗2个月时降为（9.22±2.56）％,治疗3个月时降为（8.57±2.36）％,但仍高于健康对照者（t=2.984,P=0.004）.治疗前艾滋病患者外周血Th22/Treg、Th17/Treg、Th1/Treg的比值均显著低于健康对照者,分别为0.05±0.03比0.25±0.10（t=11.69,P＜0.01）、0.46±0.27比1.07±0.42（t=7.728,P＜0.01）和1.56±0.89比3.37±1.02（t=7.052,P＜0.01）.治疗3个月时Th22/Treg、Th17/Treg、Th1/Treg的比值分别为0.17±0.10（t=6.852,P＜0.01）、0.81±0.46（t=4.253,P＜0.01）和2.31±1.27（t=3.030,P＜0.01）,与治疗前比较差异有统计学意义.相关性分析显示艾滋病患者外周血Th17/Treg比值与CD4＋T淋巴细胞呈正相关（r=0.312 5,P=0.049 6）,与HIV RNA呈显著负相关（r=-0.474 7,P=0.002 0）.Th1/Treg比值与CD4＋T淋巴细胞呈正相关（r=0.333 5,P=0.035 5）.结论 艾滋病患者Th22、Th17、Th1与Treg免疫与CD4＋T淋巴细胞密切相关,ART可部分恢复免疫功能.
Objective To investigate the changes and clinical significance of helper T cells （Th）22,Th17,Th1 and regulatory T cells （Treg） in the peripheral blood before and after antiretroviral treatment （ART） of human immunodeficiency virus （HIV）-1 infected patients.Methods Forty HIV-infected patients were recruited into this study,and 30 healthy subjects were recruited as controls.Peripheral blood of the patients was collected at baseline and after 3 months of ART treatment.The frequencies of Th22,Th17,Th1 and Treg were detected by flow cytometry.Tests for homogeneity of variance and paired t test for comparison was adopted.Spearman rank test was used for correlation analysis.Results The frequencies of peripheral Th22,Th17,Th1 and Treg from HIV-infected patients before treatment were significantly decreased compared to the healthy controls （[0.59± 0.47] ％ vs [1.65 ± 0.56] ％ [t =8.544,P＜0.01],[4.46±1.84]％ vs [6.98±1.86]％[t=5.619,P＜0.01],and [16.75±6.72]％ vs [22.77±6.87]％; [t=5.311,P＜0.01].The frequencies of peripheral Th22 and Th17 after 3 months of treatment were significantly higher than those at baseline （[1.60± 1.10] ％ [t=5.268,P＜0.01] and [6.33±2.64]％ [t=3.663,P＜0.01] and no difference from those of healthy controls （t=1.783 and 1.143,respectively; both P＞0.05）.However,the Th1 frequency showed no difference compared to the baseline.The frequency of Treg in the HIV infected patients was significantly increased compared with the healthy controls （[10.76±3.76]％ vs [7.01±1.88]％,t=5.003,P＜0.01）.However,it gradually decreased along with the ART treatment （[9.22±2.56]％ after 2 months; [8.57± 2.36]％ after 3 months）,which was still higher than that of healthy controls （t=2.984,P=0.004）.The ratios of Th22/Treg,Th17/Treg and Th1/Treg of the HIV-infected patients were significantly decreased in comparison with the healthy controls （0.05±0.03 vs 0.25±0.10,t=11.69,P＜0.01; 0.46 ± 0.27 vs 1.07±0.42,t=7.728,P＜0.01; 1.56±0.89 vs 3.37± 1.02,t=7.052,P＜0.01）,and those were significantly increased after 3 months of treatment （0.17±0.10[t=6.852,P＜0.01],0.81±0.46[t=4.253,P＜0.01] and 2.31±1.27[t=3.030,P＜0.01]）.Correlation analysis showed that the ratio of Th17/Treg of the HIV-infected patients was positively correlated with the peripheral CD4＋ T cell count （r=0.312 5,P=0.049 6）,and negatively correlated with HIV RNA viral load （r=-0.474 7,P=0.002 0）.The ratio of Th1/Treg of the HIV-infected patients was positively correlated with the peripheral CD4＋ T cell count （r=0.333 5,P=0.035 5）.Conclusions Th22,Th17,Th1 and Treg cells in the peripheral blood of HIV-infected patients are closely related to CD4＋ T cell count.ART can partially recover immune imbalance,and help to rebuild immune function of HIV-infected patients.
出处
《中华传染病杂志》
CAS
CSCD
北大核心
2015年第1期25-29,共5页
Chinese Journal of Infectious Diseases
基金
广东省自然科学基金资助项目（S2012020010873）
感染病国家临床重点学科和深圳市新发传染病重点专科、深圳市科技创新基金资助项目（JCYJ20120829093552348）
