登革热外周血髓系抑制性细胞表型特征及其临床意义  

Phenotypic characteristics and clinical significance of myeloid-derived suppressor cells in dengue patients

作　　者：郭朋乐[1] 李文莉[2] 胡凤玉[1] 张复春[1] 蔡卫平[1] 唐小平[1] 李凌华[1] Guo PL;Ha FY;Zhang FC;Cai WP;Tang XP;Li LH;Li WL(Department of Infectious Diseases, Guangzhou Eighth People＇s Hospital, Guangzhou 510060, China;Department of Infectious Diseases, Guangdong Second Provincial General Hospital, Guangzhou 510317, Chin)

机构地区：[1]广州市第八人民医院感染科,510060 [2]广东省第二人民医院感染科,广州510317

出　　处：《国际流行病学传染病学杂志》2018年第3期145-148,共4页International Journal of Epidemiology and Infectious Disease

基　　金：广州市医药卫生科技项目（20151A010057）

摘　　要：目的探讨外周血髓系抑制性细胞（MDSCs）在登革热中的表型特征及其临床意义。方法研究对象为2014年7-11月在广州市第八人民医院就诊的170例普通登革热患者，以30名健康体检者为对照，两组性别、年龄构成具有可比性。登革热患者根据就诊时的热程分为5组：发热第1之天为A组，共36倒；第3-4天为B组，共38例；第4～6天为C组，共32例；第7-8天为D组，共33例；9d及以上者为E组，共31例。用流式细胞术检测外周血MDSCs的比例，比较不同组别外周血MDSCs比例。用Spearman相关法分析MDSCs的比例与血清病毒RNA载量、发热体温、凝血时间之间的相关性。结果本组登革热患者外周血MDSCs为单核细胞型（M-MDSCs），表型为CD14＋HLA-DRNOWCD33＋CD11b＋。170例登革热患者的hmSC8比例为（4．45±0．27）％，明显高于健康对照组（t=5．191，P〈0．01）。随着热程延长，登革热患者的MDSCs比饲呈现下降趋势（居3．278，P〈0．05）。相关性分析提示，登革热患者外周血MDSCs的比例与登革热病毒载量（r=0．367）、体温（r=0．263）及凝血时间（r=0．475）呈正相关（P均〉0．01）。结论登革热患者外周血单核细胞型MDSCs比例较高，且与疾病热程及严重程度呈正相关，可能参与登革热的发病机制。Objective To explore the phenotypic characteristics and clinical significance of myeloid-derived suppressor cells （MDSCs） in the progression of （DF）. Methods There were 170 dengue patients and 30 healthy donors enrolled in Guangzhou Eighth People＇s Hospital from July to November, 2014. The sex and age compositions were comparable. The dengue patients were divided into five groups based on the length of fever at the time of the first visit： group A（n=36）, fever dayl-2; group B （n=38）, fever day3-4; group C（n=32）, fever day 4-6; group D （n=33）, fever day 7-8;and group E （n=31）, fever day ≥9. The MDSCs in peripheral blood mononuelear cells （PBMCs） were analyzed by flow cytometry. The dynamic changes of MDSCs in the progression of dengue were monitored. In addition, the correlations between MDSCs ratios and some clinical indicators such as serum dengue RNA, temperature and prothrombin time were further analyzed with Spearman correlation analysis. Results HLA- DRNOWCD11b＋CD33＋ MDSCs in dengue patients mainly belonged to CD14＋ monocytes （M-MDSCs）. The ratio of MDSCs in 170 dengue patients was （4.45±0.27）%, which was significantly higher than the healthy controls （t= 5.191, P〈0.01）. With the prolongation of fever days, the MDSCs ratio of dengue patients showed a downward trend （F=3.278, P〈0.05）. The numbers of MDSCs in dengue patients were positively correlated with dengue RNA level,body temperature and prothrombin time （r=0.367, 0.263 and 0.475, P all〈0.01）. Conclusions The proliferation of M-MDSCs is elevated in dengue patients, which may be positively related to the fever time and severity, and may be involved in the pathogenesis of dengue.

关 键 词：登革热 髓系抑制性细胞 热程 

分 类 号：R512.8[医药卫生—内科学]