HAART治疗下HIV感染者Th17/Treg的平衡及其与T细胞增殖、活化的相关性研究  

Balance of Th17/Treg and its correlation with the activation and propagation of T cells in HIV-1 infectors under HAART treatment

作　　者：朱海鹏[1] 郑玉宝[2] 曹焕焕[1] 李发武[1] 

机构地区：[1]东莞市人民医院感染科,广东东莞523059 [2]中山大学附属第三医院感染科,广东广州510630

出　　处：《热带医学杂志》2014年第7期859-863,共5页Journal of Tropical Medicine

摘　　要：目的研究接受高效抗逆转录治疗(HAART)的HIV-1感染者Th17、Treg的比例及平衡状态,及其与T细胞亚群活化的相关性,以了解Th17/Treg平衡对HAART治疗下免疫活化及疾病进展的影响。方法纳入28例HIV-1感染者(11例接受HAART治疗6个月以上、17例未治疗)及4例健康志愿者,检测并比较其血浆病毒载量、CD4细胞数、Treg、Th17亚群比例,以及HLA-DR、CD38、Ki67等的表达情况。结果 HAART治疗组的Treg及CD25-FoxP3+CD4均高于未治疗组、且表达IL-17的非CD4细胞(CD4-IL-17+)低于未治疗组,差异有统计学意义(P<0.05);Th17/Treg比值略低于未治疗组,差异无统计学意义。HAART组CD8群体中HLA-DR+CD38+、Ki67+的比例低于未治疗组,差异有统计学意义(P<0.05)。Th17比例与HLA-DR+CD38+CD4、HLA-DR+CD38+CD8及Ki67+CD8的比例呈显著正相关(P<0.05)。结论 HAART治疗的感染者高比例的Treg及CD25-FoxP3 CD4可能是其免疫抑制的重要因素。Th17细胞比例与CD8的活化与增殖及CD4的活化明显相关。调节Treg及Th17可能成为辅助治疗的新干预靶点。人类免疫缺陷病毒(human immunodeficiency virus 1,HIV-1)感染及其导致的艾滋病(acquired immune deficiency syndrome,AIDS)是严重危及人类生命健康的重大传染性疾病,迄今为止。Objective Throughinvestigation of the balance between Thl7 and Treg cells and its impact on the activation of T cells in HIV-1 infectors under HAART treatment, we try to reveal theimpact of Thl7/Treg balance onimmune activation and disease progression. Methods 28 HIV-1 infectors （11 cases had been receiving HAART treatment for more than 6 months and 17 cases were HAART-naive） and 4 healthy donors were enrolled into our research. Their CD4 counts, regulatory T cells and T helper 17 cells expression of HLA-DR, CD38, Ki67 were also be determined. Results Patients in HAART treatment group have significant higher Treg and CD25-FoxP3＋CD4 proportion,and lower IL-17 expressing non-CD4（CD4-IL-17＋） proportion than in HAART naYve group （P〈0.05）. The ratio of Thl7/Treg in HAART treatment was also less than in untreated group, while the difference was not significant. The percentagesof both HLA- DR＋CD38＋CD8 and Ki67＋CD8 cells were also lower in HAART treatment group than in untreated group （P〈0.05）. Moreover,there weresignificant positive correlations between Thl7 proportion and HLA-DR＋CD38＋CD4, HLA-DR＋CD38＋ CD8 and Ki67＋CD8 proportions （P〈0.05）. Conclusions The higher proportion of Treg and CD25-FoxP3 CD4 would be critical in the immunosuppressionof HAART treated patients. Thl7 is significantly correlated with the activation of CD8, CD4, as well as the propagation of CD4. Targeting the regulation Thl7 and Treg, new strategies would be developed as supplementary therapies to HAART.

关 键 词：高效抗逆转录病毒治疗 调节性T细胞 T辅助细胞17 活化 增殖 

分 类 号：R512.91[医药卫生—内科学]