局部44℃温热治疗尖锐湿疣的效果及对外周血CD4^+CD25^+Foxp3^+调节性T细胞及相关因子的影响  

Effect of local hyperthermia at 44℃ on peripheral blood of CD4^+CD25^+Foxp3^+ regulatory T cells and correlation factors in condyloma acuminatum

作　　者：陈卫丰[1] 

机构地区：[1]湖南省益阳市中心医院皮肤科,湖南益阳413000

出　　处：《中国医药导报》2015年第26期107-110,共4页China Medical Herald

摘　　要：目的探讨局部44℃温热治疗尖锐湿疣的效果及对外周血CD4+CD25+Foxp3+调节性T细胞(CD4+CD25+Foxp3+Treg细胞)及相关因子的影响,以研究其在尖锐湿疣发病机制中的作用。方法选取2013年1月~2015年4月益阳市中心医院皮肤科门诊就诊的尖锐湿疣患者35例(CA组),正常者35例作为对照组,CA组应用局部44℃温热治疗,3个月后评价疗效并测定治疗前后外周血血清中CD4+CD25+Foxp3+Treg细胞和相关因子水平,并与对照组进行比较分析。结果 CA组患者外周血CD4+CD25+Treg细胞、CD4+CD25+Foxp3+Treg细胞百分比及CD4+CD25+T细胞表面抑制性膜分子CTLA-4、GITR、PD-L表达均明显高于对照组(t=9.52、15.07、8.63、9.16、10.92,均P<0.05);胞内IL-10和TGF-β阳性细胞百分比较对照组增多(t=3.22,7.02,均P<0.05);CA组治疗3个月,总有效率为85.71%(30/35),治疗中未见明显副作用。外周血CD4+CD25+Treg细胞、CD4+CD25+Foxp3+Treg细胞百分比、CTLA-4、GITR、PD-L水平及IL-10、TGF-β阳性细胞百分比均较治疗前显著降低,差异均有统计学意义(t=7.76、12.91、7.46、7.68、9.29、2.64、6.01,均P<0.05)。结论 HPV感染可活化增殖CD4+CD25+Foxp3+Treg细胞,其高表达协同刺激分子和抑制性细胞因子,温热治疗尖锐湿疣安全有效,其治疗机制可能与调节CD4+CD25+Foxp3+Treg细胞及相关因子有关。Objective To investigate the curative effects of local hyperthermia at 44℃ on peripheral blood of CD4＋CD25＋Foxp3＋regulatory T cells and correlation factors in condyloma acuminatum （CA）, so as to investigate the patho-genesy of CA. Methods From January 2013 to April 2015, 35 patients with condyloma acuminatum in Yiyang Central Hospital were selected, and 35 normal cases were selected as control group. The CA group were given local hyperther-mia at 44℃ therapy, and the concentrations of CD4＋CD25＋Foxp3＋ regulatory T cells and correlation factor in serum were detected before and after treatment, then the therapeutic effect after 3 months was assessed. And comparative analysis with the control group was proceeded. Results The number of CD4＋CD25＋Tregs, CD4＋CD25＋Foxp3＋Tregs and the expressions of CTLA-4, GITR and PD-L were increased significantly in peripheral blood of patients in CA group, and higher than those of the control group （t =9.52, 15.07, 8.63, 9.16, 10.92, all P〈0.05）. The numbers of IL-10 and TGF-β in CD4＋CD25＋ T cells were significantly increased in peripheral blood of patients compared with those from control group（t =3.22, 7.02,P〈0.05）. The percent of positive cell of CD4＋CD25＋Tregs, CD4＋CD25＋Foxp3＋Tregs and the expressions levels of CTLA-4, GITR, PD-L, and percent of positive cell of IL-10 and TGF-β of the CA group after treatment were lower than those before treatment （t =7.76, 12.91, 7.46, 7.68, 9.29, 2.64, 6.01, all P〈 0.05）. Conclu-sion HPV infection can result in the activation and proliferation of CD4＋CD25＋Tregs, its expression of high levels al-lostimulatory molecules and suppressive cytokines. Local themotherapy at 44℃is a safe and effective single modality in the treatment of CA, the mechanism may be through the regulation of the expressions of CD4＋CD25＋Foxp3＋regulatory T cells and correlation factors.

关 键 词：44℃温热 尖锐湿疣 调节性T细胞 

分 类 号：R752.5[医药卫生—皮肤病学与性病学]