CD14基因多态性与严重烧伤患者T淋巴细胞免疫功能的相关性研究  

Study on the correlation between CD14 gene polymorphism and T cell-mediated immunity in severely burned patients

作　　者：董宁[1] 姚咏明[1] 于燕[1] 曹玉珏 贺立新 杨红明[1] 盛志勇[1] 

机构地区：[1]解放军总医院第一附属医院全军烧伤研究所,北京100037 [2]北京佑安门医院烧伤科

出　　处：《中华外科杂志》2009年第8期617-620,共4页Chinese Journal of Surgery

基　　金：国家重点基础研究发展规划资助项目（2005CB522602）;国家自然科学基金资助项目（30125020,30872683）;首都医学发展基金重点资助项目（2003-2023）

摘　　要：目的探讨严重烧伤患者CD14基因多态性与T淋巴细胞免疫功能的关系。方法采集77例烧伤体表总面积大于30％患者血标本，通过聚合酶链反应-限制性片段长度多态性方法检测CD14—159C／T基因多态性，观察其外周血T淋巴细胞增殖反应和白细胞介素-2（IL-2）的产生能力，并通过流式细胞仪检测T淋巴细胞CD4^＋／CD8^＋的比值、CD4^＋细胞的凋亡率。结果严重烧伤后患者T淋巴细胞增殖能力明显下降，与CC纯合子患者比较，TT、TC基因型患者伤后第5、21、28天T淋巴细胞对丝裂原刺激增殖反应显著受抑（P〈0．05或P〈0．01）。烧伤后携带TC、TT型患者IL-2产生一直处于较低水平，而CC型在伤后14d分泌IL-2逐渐上升。与CC型患者比较，携带TF、TC型患者T淋巴细胞比值均降低，尤其在伤后第1、3、14、21、28天差异明显（P〈0．05或P〈0．01）。三型CD3^＋CD4^＋T淋巴细胞凋亡率比较，TT型患者伤后第5、7、21天凋亡率显著高于CC型患者（P〈0．05），TC型患者伤后7、14d其凋亡率高于CC型患者（P〈0．05），而TF、TC型之间上述免疫功能指标比较均无显著差异（P〉0．05）。结论CD14—159C／T多态性可影响大面积烧伤患者T淋巴细胞免疫功能状态，进而参与了严重感染并发症的发生与发展过程。Objective To investigate the correlation between CD14 gene polymorphism and T cellmediated immunity in severely burned patients. Methods The blood samples of 77 patients with extensive burn injury （ 〉 30% total body surface area） were collected, and CD14-159C/T gene polymorphism was determined by polymerase chain reaction-restriction fragment length polymorphism （PCR-RFLP）. T lymphocyte cell proliferation and interleukin-2 （IL-2） production were determined, and the ratio of CD4^＋/CD8^＋ T lymphocyte as well as apoptosis of CD4^＋ T lymphocyte was examined by flow cytometry. Results The ability of T lymphocyte proliferation was obviously decreased in severely burned patients. Compared with CC homozygote patients, proliferative activity of T lymphocyte to mitogen stimulation was significantly depressed in TT and TC patients on post burn days 5, 21, and 28 （P 〈0. 05 or P 〈0. 01 ）. IL-2 production in TT, TC patients was constantly in low level after burns, while it was increased from post burn day 14 in CC patients. The ratio of CD4^＋/CD8^＋ T lymphoeytes was markedly decreased in TC, TT patients than that in CC patients, especially on post burn days 1, 3, 14, 21, and 28 （P 〈 0. 05 or P 〈 0. 01 ）. Meanwhile, compared with CC homozygote patients, the apoptosis rates of CD3^＋ CD4^＋ T lymphocytes were much higher in TT patients on post burn days 5, 7, and 21 （ P 〈 0. 05 ） , and in TC patients on days 7, 14 （P 〈 0. 05 ） , respectively. However, no obvious differences in parameters of immune function of T lymphocytes were found between TT and TC patients （ P 〉 0. 05 ）. Conclusion CD14-159C/T polymorphism could influence the T cell-mediated immunity in extensively burned patients, which might participate in the development of septic complications secondary to major burns.

关 键 词：抗原 CD14 T淋巴细胞 基因 烧伤 脓毒症 

分 类 号：R686[医药卫生—骨科学]