人巨细胞病毒感染介导免疫应答对结缔组织病相关性间质性肺病发生的影响  

Effects of human cytomegalovirus infection-mediated immune response on the occurrence of connective tissue disease-related interstitial lung disease

作　　者：潘美芳 杨旭艳 付瑜 高涛 郑超 PAN Mei-fang;YANG Xu-yan;FU Yu;GAO Tao;ZHENG Chao(Yiwu Fuyuan Hospital,Yiwu,Zhejiang322000,China;不详)

机构地区：[1]义乌市復元医院风湿免疫科,浙江义乌322000 [2]浙江大学医学院附属第二医院风湿免疫科,浙江杭州310000 [3]义乌市復元医院呼吸科,浙江义乌322000

出　　处：《中华医院感染学杂志》2023年第7期1021-1024,共4页Chinese Journal of Nosocomiology

基　　金：浙江省科研计划资助项目(2021WJ223)。

摘　　要：目的探究人巨细胞病毒(HCMV)感染介导免疫应答对结缔组织病(CTD)相关性间质性肺病(ILD)发生的影响。方法选取2019年6月-2021年12月医院收治的CTD-ILD患者187例,根据是否发生HCMV感染分为感染组65例和未感染组122例。采用流式细胞仪检测外周血T淋巴细胞亚群(CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+))水平,酶联免疫吸附法检测辅助性T细胞(Th)因子干扰素-γ(IFN-γ)、白细胞介素-4(IL-4)及补体系统激活标志物CBb、C1q、C3a水平,免疫散射比浊法检测免疫球蛋白(Ig)(IgA、IgG、IgM)和补体(C3、C4)水平,并分析HCMV DNA载量与上述指标的相关性。结果感染组外周血CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)、IFN-γ、IFN-γ/IL-4和CBb水平低于未感染组,CD_(8)^(+)细胞占比、IL-4、IgA、IgG、IgM、C3、C4、C1q和C3a高于未感染组(P<0.05);相关性分析结果显示,HCMV DNA载量分别与CD_(4)^(+)/CD_(8)^(+)和IFN-γ/IL-4呈负相关,与IgG、C3、C1q和C3a呈正相关(P<0.05)。结论HCMV可能通过激活补体系统,调控Th1/Th2平衡,参与CTD-ILD的发生。OBJECTIVE To explore the effect of human cytomegalovirus(HCMV)infection-mediated immune response on the occurrence of connective tissue disease(CTD)-related interstitial lung disease(ILD).METHODS A total of 187 patients with CTD-ILD admitted to the hospital between Jun 2019 and Dec 2021 were enrolled.According to presence or absence of HCMV infection,they were divided into the infection group(65 cases)and non-infection group(122 cases).The levels of peripheral blood T lymphocyte subsets(CD_(4)^(+),CD_(8)^(+),CD_(4)^(+)/CD_(8)^(+))were detected by flow cytometry.The levels of helper T cells(Th)factors[interferonγ(IFN-γ),interleukin 4(IL-4)]and complement system activation markers(CBb,C1q,C3a)were detected by enzyme-linked immunosorbent assay.The levels of immunoglobulins(IgA,IgG,IgM)and complements(C3,C4)were detected by immunoturbidimetry.The correlation between HCMV DNA load and the above indexes was analyzed.RESULTS The levels of peripheral blood CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+),IFN-γ,IFN-γ/IL-4 and CBb in the infection group were lower than those in the non-infection group,while proportion of CD_(8)^(+),IL-4,IgA,IgG,IgM,C3,C4,C1q and C3a were higher than those in the non-infection group(P<0.05).Correlation analysis showed that HCMV DNA load was negatively correlated with CD_(4)^(+)/CD_(8)^(+)and IFN-γ/IL-4,while positively correlated with IgG,C3,C1q and C3a(P<0.05).CONCLUSION HCMV may participate in the occurrence of CTD-ILD by activating complement system and regulating Th1/Th2 balance.

关 键 词：人类巨细胞病毒感染 结缔组织病 间质性肺病 TH1/TH2 补体系统 

分 类 号：R563.9[医药卫生—呼吸系统]