活化型血小板-CD4细胞聚合体与HIV/AIDS患者免疫状态的关系  

The relationship between activated platelet-CD4+T cell aggregates and the immune status of HIV/AIDS patients

作　　者：蒋梅青 王芯栎 赵萌 杜娟[1,2,3,4,5] 赵红心[1,7] 孔雅娴 JIANG Meiqing;WANG Xinyue;ZHAO Meng;DU Juan;ZHAO Hongxin;KONG Yaxian(Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China;Beijing Key Laboratory of Emerging Infectious Diseases,Institute of Infectious Diseases,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China;Beijing Institute of Infectious Diseases,Beijing 100015,China;National Center for Infectious Diseases,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China;National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases,Beijing 100015,China;Peking University Ditan Teaching Hospital,Beijing 100015,China;Clinical Center for AIDS,Beijing Ditan Hospital,Capital Medical University Beijing 100015,China)

机构地区：[1]首都医科大学附属北京地坛医院,北京100015 [2]首都医科大学附属北京地坛医院传染病研究所,新发突发传染病研究北京市重点实验室,北京100015 [3]北京市感染性疾病研究中心,北京100015 [4]国家传染病医学中心,首都医科大学附属北京地坛医院,北京100015 [5]传染病溯源预警与智能决策全国重点实验室,北京100015 [6]北京大学地坛医院教学医院,北京100015 [7]首都医科大学附属北京地坛医院艾滋病临床中心,北京100015

出　　处：《中国艾滋病性病》2024年第2期131-139,共9页Chinese Journal of Aids & STD

基　　金：北京市杰出青年科学基金项目(JQ21023);北京市高层次公共卫生技术人才建设项目(学科骨干-02-27);北京市医管中心项目(DFL20191802);北京市医院管理局临床医学发展专项(ZYLX202126)。

摘　　要：目的分析HIV/AIDS患者不同疾病状态下外周血中CD4细胞与活化血小板形成聚合体的比例变化,并探讨活化型血小板-CD4细胞聚合体聚集的原因及与疾病进展的关系。方法入组符合标准的100例未经cART的HIV/AIDS患者(TN),18例经cART治疗后的免疫应答(IR)者,13例免疫无应答(INR)者与20例健康对照(HC)。利用流式细胞术检测活化型血小板-CD4细胞聚合体的比例和血小板及CD4细胞的自身活化程度,探究活化型血小板-CD4细胞聚合体比例变化特点、与疾病进展的关系以及参与聚合体形成的影响因素。结果TN组活化型血小板-CD4细胞聚合体比例显著升高(TN vs.HC:中位数6.420 vs.5.200,Z=2.093,P=0.0332),且该比例与CD4细胞计数、CD4/CD8细胞比值呈显著负相关(CD4细胞计数,r=-0.5530,P<0.0001;CD4/CD8细胞比值,r=-0.6015,P<0.0001),与病毒载量呈显著正相关(r=0.3298,P=0.0010)。经cART后,IR组较TN组活化型血小板-CD4细胞聚合体比例显著降低(IR vs.TN:中位数4.535 vs.6.420,Z=2.776,P=0.0053),而INR组未见降低(INR vs.TN:中位数6.730 vs.6.420,Z=0.6542,P=0.5112)。TN组外周血中活化型血小板-CD4细胞聚合体比例与HLA-DR+CD4+T细胞比例呈正相关(r=0.4262,P=0.0055),而与血小板计数及血小板活化水平无相关性。结论活化型血小板-CD4细胞聚合体比例与HIV/AIDS患者疾病进程及cART效果密切相关,且该聚合体的形成主要受CD4细胞自身活化程度影响。Objective To explore the proportion of activated platelet-CD4+T cell aggregates in the peripheral blood of HIV/AIDS patients in different disease states,and to investigate the reasons for the aggregation of activated platelet-CD4+cell aggregates and their relationship with disease progression.Methods A cohort of 100 treatment-naïve HIV/AIDS patients(TN),18 immunological responders(IR)postcombination antiretroviral therapy(cART),13 immunological non-responders(INR),and 20 healthy controls(HC)were enrolled.Flow cytometry was used to determine the proportion of activated platelet-CD4+T cell aggregates and the self-activation levels in both platelets and CD4+T cells,with the aim of investigating changes in the proportion of activated platelet-CD4+T cell aggregates,their relationship with disease progression,and the influencing factors involved in aggregate formation.Results The proportion of activated platelet-CD4+T cell aggregates was significantly higher in the TN group(TN vs.HC:median 6.420 vs.5.200,Z=2.093,P=0.0332),and this proportion was negatively correlated with CD4+T cell count and the CD4+/CD8+ratio(CD4+T count,r=-0.5530,P<0.0001;CD4+/CD8+ratio,r=-0.6015,P<0.0001),and positively correlated with viral load(r=0.3298,P=0.0010).After cART,the proportion of activated platelet-CD4+T cell aggregates was significantly lower in the IR group than in the TN group(IR vs.TN:median 4.535 vs.6.420,Z=2.776,P=0.0053),whereas no reduction was observed in the INR group(INR vs.TN:median 6.730 vs.6.420,Z=0.6542,P=0.5112).The proportion of activated platelet-CD4+T cell aggregates in the peripheral blood of the TN group was positively correlated with the proportion of HLA-DR+CD4+T cells(r=0.4262,P=0.0055),but showed no correlation with the platelet count and platelet activation level.Conclusions The proportion of activated platelet-CD4+T cell aggregates is closely related to the disease progression in HIV/AIDS patients and the efficacy of cART,and the formation of these aggregates is primarily influenced by the activation level

关 键 词：1型艾滋病病毒 活化血小板-CD4细胞聚合体 血小板 CD4细胞 

分 类 号：R373.9[医药卫生—病原生物学]