IL-4基因多态性与HIV/AIDS患者肺孢子虫肺炎易感性的关系  

Correlation between IL-4 gene polymorphism and susceptibility to pneumocystis pneumoniae infection in HIV/AIDS patients

作　　者：魏文惠 唐仕萍 胡大兰 古清燕 王英 WEI Wen-hui;TANG Shi-ping;HU Da-lan;GU Qing-yan;WANG Ying(Affiliated Hospital of Southwest Medical University,Luzhou,Sichuan 646000,China)

机构地区：[1]西南医科大学附属医院感染病科、结核科、感染与免疫实验室,四川泸州646000

出　　处：《中华医院感染学杂志》2020年第22期3399-3403,共5页Chinese Journal of Nosocomiology

基　　金：四川省卫生厅科研基金资助项目(16156)。

摘　　要：目的探讨白细胞介素-4(IL-4)基因多态性与人获得性免疫缺陷病毒/艾滋病(HIV/AIDS)患者肺孢子菌肺炎(PCP)感染易感性及患者免疫状态的关系。方法选择西南医科大学附属医院感染科2018年3月-2020年1月收治的HIV/AIDS患者162例,根据是否合并PCP分为PCP组(n=49)和非PCP组(n=113),此外根据PCP严重程度将PCP组分为轻度组、中度组及重度组。比较不同分组患者C-反应蛋白(CRP)、降钙素原(PCT)及红细胞沉降率(ESR)及IL-4水平及免疫细胞CD4+T细胞绝对计数、CD4+/CD8+。采用Sanger测序法检测IL-4基因rs2243250位点多态性。结果 PCP组CRP、PCT、ESR、IL-4水平高于非PCP组,CD4+T细胞绝对计数、CD4+/CD8+水平低于非PCP组;重度组CRP、PCT、ESR、IL-4水平高于轻度组及中度组,CD4+T细胞绝对计数、CD4+/CD8+水平低于轻度组及中度组,中度组CRP、PCT、ESR、IL-4水平高于轻度组,CD4+T细胞绝对计数、CD4+/CD8+水平低于轻度组;两组IL-4基因rs2243250位点CT基因型频率无统计学差异,PCP组TT基因型、T等位基因频率高于非PCP组(P<0.05)。结论血清IL-4水平对于区分是否存在PCP及PCP严重程度具有一定的临床价值,IL-4基因rs2243250位点多态性可能是影响HIV/AIDS患者对PCP易感性的因素之一。OBJECTIVE To explore the relationship between interleukin-4(IL-4) gene polymorphism and the susceptibility to pneumocystis pneumonia(PCP) infection and the immune status of patients with human acquired immunodeficiency virus/AIDS(HIV/AIDS). METHODS Totally 162 HIV/AIDS patients who were admitted to the department of infectious diseases of the Affiliated Hospital of Southwest Medical University from Mar 2018 to Jan 2020 were selected and divided into the PCP group with 49 cases and the non-PCP group with 113 cases according to the status of combination with PCP, and the patients were divided into the mild group, the moderate group and the severe group. The levels of C-reactive protein(CRP), procalcitonin(PCT) and erythrocyte sedimentation rate(ESR) as well as IL-4 level, absolute counts of CD4+ T cells and CD4+/CD8+ were observed and compared among the different groups of patients, and the IL-4 gene rs2243250 polymorphism was detected by using Sanger sequencing method. RESULTS The levels of CRP, PCT, ESR and IL-4 of the PCP group were higher than those of the non-PCP group, the absolute counts of CD4+T cells and CD4+/CD8+ of the PCP group were lower than those of the non-PCP group. The levels of CRP, PCT, ESR and IL-4 of the severe group were higher than those of the mild group and the moderate group, the absolute counts of CD4+T cells and CD4+/CD8+ of the severe group were lower than those of the mild group and the moderate group;the levels of CRP, PCT, ESR and IL-4 of the moderate group were higher than those of the mild group, and the absolute counts of CD4+T cells and CD4+/CD8+ of the moderate group were lower than those of the mild group. There was no significant difference in the CT genotype frequency of IL-4 gene rs2243250 locus between the two groups, and the TT genotype, T allele frequency of the PCP group was significantly higher than that of the non-PCP group(P<0.05). CONCLUSION The serum IL-4 level has certain clinical value in distinguishing the existence of PCP and the severity of PCP. The rs2243250

关 键 词：单核苷酸多态性 白细胞介素-4 肺孢子虫肺炎 获得性免疫缺陷病毒 艾滋病 

分 类 号：R512.91[医药卫生—内科学]