HIV／TB重叠感染者HAART治疗前后Th17／Treg免疫调节的初步研究  

Preliminary study of the Th17/Treg immunoregulation in patients coinfected with TB and HIV before and after HAART

作　　者：刘映霞[1] 杨桂林[1] 周泱[1] 张红梅[1] 张洁云[1] 王思苑[1] 刘艳[1] 刘水腾[1] 张路坤[1] 王辉[1] 

机构地区：[1]深圳市第三人民医院感染科,广东518020

出　　处：《中华实验和临床病毒学杂志》2011年第5期348-350,共3页Chinese Journal of Experimental and Clinical Virology

基　　金：基金项目：广东省自然科学基金资助（9151051501000032）

摘　　要：目的初步探讨HIV／TB重叠感染者在高抗逆转录病毒治疗（HAART）治疗前后Th17／Treg的免疫调节作用。方法HIV／TB重叠感染者（HIV／TB组）10例和单纯HIV感染者（HIV组）10例分别接受HAART治疗，应用流式细胞术分析患者HAART治疗前和治疗后1个月的外周血Th17和CD4＋CD25＋调节性T细胞（Treg）细胞表型。结果HIV／TB组IL-17＋CD4＋T细胞的百分率在治疗前后分别为1．90％±0．9％和4．65％±1．48％，HIV／TB组在治疗后较治疗前IL—17＋T细胞升高，差异有统计学意义（P〈0．01）；HAART治疗前后IL-17的百分率差值在HIV／TB组与HIV组中分别为2．65％±1．62％，0．67％±0．46％，HIV／TB组治疗后IL-17＋T的上升速度显著高于单纯HIV感染组（P〈0．01）。HIV／TB组Treg的百分率在治疗前后分别为16．48％±4．91％，8．29％±3．13％，治疗前后差异有统计学意义（P〈0．01）；治疗前后Treg的百分率差值在HIV／TB组与HIV组中分别为8．91％±4．82％，2．63％±2．34％，HIV／TB组治疗后Treg下降速度高于HIV组，差异有统计学意义（P〈0．01）。结论TB和HAART治疗均影响Th17／Treg的免疫应答，Th17表达上调，促炎作用增强，Treg表达下调，抑炎作用减弱，而且HIV／TB重叠感染者在HAART治疗过程中更容易出现Th17／Treg平衡紊乱，可能与HAART治疗后出现结核性免疫重建综合征有相关性。Objective To study the Th17/Treg （regulatory T cells） immunoregulation in patients coinfected with TB and HIV before and after HAART（highly active anti-retroviral therapy）. Methods 10 HIV cases coinfected with TB （HIV/TB group） and 10 cases infected with HIV only （HIV group） received HAART. PBMCs were stained and immunophenotyping of Thl7 （ IL-17 expressing T cells） and CD4 ＋ CD25 ＋ T cells （Treg） were analysed by flow cytometry. Results The pre-treatment patients tended to have lower Thl7 cells and higher Tregs cells compared to post-treatment（1.90% ± 0. 9% vs. 4. 65% ±1.48%, 16.48% ±4. 91% vs. 8.29% ± 3.13% respectively）. The percentage of IL-17 before and after HAART were 1.90 ± 0.9% vs. 4.65 ±1.48% respectively in HIV/TB group patients （P 〈 0. 01 ）. The difference between the percentage of IL-17 before and after HAART in the HIV/TB group and the HIV group were 2. 65 ± 1.62% vs. 0. 67% ±0. 46% respectively （P 〈0. 01 ）. IL-17 expressing T cells were increased faster after HAART in the former group than the latter. The percentage of Treg before and after HAART were 16.48% ± 4.91% vs. 8.29% ± 3.13% respectively in HIV/TB group （ P 〈 0. 01 ）. The difference between the percentage of Treg before and after HAART in the HIV/TB group and the HIV group were 8.91%± 4.82% vs. 2.63% ±2. 34% respectively （P 〈 0. 01 ）. Treg were decreased more rapidly after HAART in the former than the latter. Conclusions TB and HAART both had an effect on the Th17/Treg ratio of HIV/ TB co-infected patients, which can cause increased Th17 expression, the later plays a pro-inflammatory role.TB and HAART can decrease Treg expression and enhance anti-inflammation response. The fact that Th17/ Treg disorder are more likely to exist in patients with HIV/TB co-infection after HAART for one month suggests a potential role for Th17/Treg imbalance leading to tuberculosis-associated immune reconstitution inflammatory syndrome during patients receiving HAART period.

关 键 词：CD4阳性T淋巴细胞 HIV 分枝杆菌 结核 感染 

分 类 号：R512.91[医药卫生—内科学]