男男性行为人群HIV感染不同病程阶段T淋巴细胞亚型分布及稳态变化的研究  

Changes in CD4+ T lymphocyte subset distribution and homeostasis in MSM population with different stages of HIV infection

作　　者：张亚兰[1] 郑海潮[1] 卫晓丽[1] 张海兰[1] 杨扬[1] 赵鑫[1] 于彤彤[1] Zhang Yalan;Zheng Haichao;Wei Xiaoli;Zhang Hailan;Yang Yang;Zhao Xin;Yu Tongtong(Department of AIDS Control and Prevention,Xi'an Center for Disease Control and Prevention,Xi'an 710054, China)

机构地区：[1]西安市疾病预防控制中心性病艾滋病防治所,710054

出　　处：《中华微生物学和免疫学杂志》2018年第12期908-913,共6页Chinese Journal of Microbiology and Immunology

基　　金：陕西省社会发展科技攻关项目(2015SF192).

摘　　要：目的探讨T淋巴细胞亚群分布及稳态变化在男男性行为人群(men who have sex with men,MSM)艾滋病病毒(human immunodeficiency virus,HIV)感染疾病进展中的作用。方法166例男男性行为人群HIV感染样本,依据感染时间及CD4^+T淋巴细胞水平分组:早期感染组(early HIV infection,EHI)38例、HIV组94例、AIDS组34例,62例HIV抗体阴性MSM作为健康对照,用EDTA抗凝管采集全血,流式细胞术检测CD4^+T、CD8^+T淋巴细胞亚群(CD4^+CD45RA+、CD8^+CD28^+、CD4^+CD25^+CD127^-)及活化(CD38、HLA-DR)与凋亡(CD95)细胞表达频率。结果随着疾病进展,CD4^+CD45RA+T淋巴细胞表达逐步降低,HIV组低于对照组,AIDS组低于HIV组,差异有统计学意义(P=0.015,P=0.000),而EHI组与对照组比较差异无统计学意义(P>0.05)。CD8^+CD28^+T细胞在EHI组出现明显降低,HIV组和AIDS组持续在较低水平。调节性T细胞(CD4^+CD25^+CD127^-)亚群比例各组间差异无统计学意义(P>0.05)。CD4活化细胞(CD4^+CD38^+HLA-DR^+)百分比逐级上升,表现为对照组<EHI组<HIV组<AIDS组,差异有统计学意义(P<0.01);CD8活化亚群(CD8^+CD38^+,CD8^+HLA-DR^+,CD8^+CD38^+HLA-DR^+)和CD8凋亡细胞亚群(CD8^+CD95^+)均表现为EHI组、HIV组和AIDS组显著高于阴性对照组(P<0.01),但前3组间两两比较,活化及凋亡亚群差异均无统计学意义(P>0.05)。结论HIV感染后T淋巴细胞各亚群的数量、功能均发生改变,活化及凋亡细胞比例增加,进一步加重免疫功能损伤,T细胞亚型重新分布及稳态变化可能是疾病进展的影响因素。CD4^+T和CD8^+T淋巴细胞在HIV感染的早期已经发生免疫活化,对这一阶段免疫应答的研究将是探讨其在疾病进展中发挥作用的重要时机。Objective To investigate the changes in the percentages of CD4^+ T lymphocyte subsets and the homeostasis of T lymphocytes among MSM (men who have sex with men) population with different stages of HIV-1 infection. Methods A total of 166 untreated MSM with HIV infection were enrolled and divided into three groups including early HIV infection (EHI, n=38) , HIV (n=94) and AIDS (n=34) groups. Sixty-two MSM negative for anti-HIV antibody were selected as healthy controls. Blood samples were collected into EDTA tubes and detected to analyze the changes in the distribution of CD4^+ T cells and CD8^+ T lymphocyte subsets (CD4^+ CD45RA+ , CD8^+ CD28^+ , CD4^+ CD25^+ CD127^-) and the percentages of activated (CD38, HLA-DR) and apoptotic cells (CD95) with disease progression by flow cytometry. Results The expression of CD4^+ CD45RA+ T lymphocytes gradually decreased with the progression of AIDS. The percentage of CD4^+ CD45RA+ T lymphocytes in HIV group was lower than that of the control group, but higher than that of the AIDS group (P=0.015, P=0.000). No significant difference was found between the EHI and the control groups (P>0.05). CD8^+ CD28^+ T cells were significantly reduced in the EHI group and remained at a low level with disease progression. No significant difference in the proportion of CD4^+ CD25^+ CD127^- T cells was observed among all groups (P>0.05). The percentage of CD4^+ CD38^+ HLA-DR^+ T cells increased gradually and the highest level was detected in the AIDS group, followed by those in the HIV, EHI and control groups (P<0.01). The percentages of CD8^+ CD38^+ , CD8^+ HLA-DR^+ , CD8^+ CD38^+ HLA-DR^+ and CD8^+ CD95^+ T cells in the EHI, HIV and AIDS groups were significantly higher than those in the control group (P<0.01), but there was no significant difference among the former three groups (P>0.05). Conclusion HIV infection caused the changes in the numbers and functions of T lymphocyte subsets and accelerated the activation and apoptosis of T lymphocytes, which aggravated the T lymphocyte immune dysfu

关 键 词：HIV 早期感染(EHI) 活化 T细胞稳态 疾病进展 

分 类 号：R512.91[医药卫生—内科学]