HAART对HIV感染者NK细胞FcγRII表达及疾病进展的影响  

Influence of HAART to the Fc gamma RⅡexpression of NK cells and disease progression in HIV infected people

作　　者：毛卓君 刘清泉[1] 庄严[1] 党便利 汪春付[1] 申焕君[1] 孙永涛[1] 

机构地区：[1]第四军医大学附属唐都医院感染科,西安710038

出　　处：《中国艾滋病性病》2016年第7期498-502,共5页Chinese Journal of Aids & STD

基　　金：国家"十二五"科技重大专项(2012ZX10001-006)~~

摘　　要：目的研究艾滋病病毒(HIV)感染者外周血中自然杀伤细胞(NK cells)亚群的比例,各亚群细胞对CD32A/CD32B/CD57的表达水平,高效抗反转录病毒治疗(HAART)与疾病进展的相关性。方法对未经治疗的慢性HIV感染者35例和进展期患者23例,分析NK细胞各亚群的比例,各亚群细胞对CD32A/CD32B/CD57的表达水平,CD4+T淋巴细胞(简称CD4细胞)、CD8+T淋巴细胞(简称CD8细胞)计数及CD4/CD8比值,并对以上各因素进行相关性分析。以上患者中选14例慢性HIV感染者、10例进展期患者进行HAART治疗(替诺福韦+拉米夫定+依非韦伦)6个月,分析治疗对以上因素的影响。结果机体感染HIV后,CD56dimNK细胞的比例下降,CD56neg NK细胞的比例升高(P<0.0005);CD57+CD56dimNK细胞、CD57+CD56neg NK细胞的比例下降(P<0.05),CD32B+CD56dim NK细胞、CD32B+CD56neg NK细胞的比例升高(P<0.05)。CD56dimNK细胞比例与CD4/CD8比值正相关(P=0.0176,r2=0.0813),CD56neg NK细胞比例与CD4/CD8比值呈负相关(P=0.0293,r2=0.0689)。经过治疗的慢性HIV患者的CD56bright NK细胞的比例降低(P<0.05),所有患者的CD4细胞计数及CD4/CD8比值升高(P<0.01)。结论 HIV通过抑制NK细胞成熟增加抑制型受体表达,改变NK细胞亚群比例来抑制NK细胞功能。有效的HAART治疗可以恢复HIV患者CD4细胞计数及CD4/CD8比值,促进免疫重建,降低死亡概率。Objective To study the relevance between natural killer cells（NK）subset proportion in peripheral blood of human immunodeficiency virus（HIV）infected people,expression levels of CD32A/CD32BCD57 in each subset,highly active antiretroviral therapy（HAART）and disease progression.Methods We analyzed the proportion of each NK subset,the CD32A/CD32B/CD57 expression level of each subset,CD4＋T and CD8＋T cell count and CD4/CD8 ratio,and the correlation of all factors in 35 untreated chronic HIV infected people and 23 untreated progressors,among which 14 chronic HIV infected people and 10 progressors were selected for HAART（TDF＋3TC＋EFV）for six months so as to see the effect of treatment.Results In the HIV infected people,the proportion of CD56 dimNK cells declined,and the proportion of CD56 neg NK increased（P〈0.0005）;the ratio of CD57＋CD56dim NK and CD57＋CD56neg NK declined（P〈0.05）,while the ratio of CD32B＋CD56dimNK and CD32B＋CD56neg NK increased（P〈0.05）.The proportions of CD56 dimNK were positively correlated with CD4/CD8ratio（r2=0.0813,P= 0.0176）,and the proportions of CD56 neg NK were negatively correlated with CD4/CD8ratio（r2= 0.0689,P =0.0293）.Treatment reduced the proportion of CD56 bright NK in chronic HIV infected group（P〈0.05）,and increased the proportion of CD4＋T cells count and CD4/CD8ratio（P〈0.01）.Conclusion HIV can inhibit NK cells mature,increase inhibitory receptor expression and change the proportion of NK subsets to downgrade the function of NK cells.After effective HAART treatment,body can restore the CD4＋T cells count and CD4/CD8 ratio,promote immune reconstruction,and reduce death rate.

关 键 词：艾滋病病毒 自然杀伤细胞 FcγRII 高效抗反转录病毒治疗 疾病进展 

分 类 号：R512.91[医药卫生—内科学]