单纯疱疹-Ⅱ型病毒感染的皮损部位病毒载量与外周血Th及Tc的相关性研究

Study on the Relationships between Herpes Simplex Virus Type Ⅱ Infection and the Proportions of Th and Tc Lymphocytes in Peripheral Blood

目的通过检测现症生殖器疱疹(genital herpes,GH)病人皮损部位的单纯疱疹2型病毒(HSV-2)载量,并检测其细胞免疫功能,分析GH患者HSV-2病毒载量与细胞免疫功能的相关性。方法采用荧光定量聚合酶链反应(fluorescent quantitative polymerase chain reaction,FQ-PCR)定量检测28例现症GH患者皮损部位HSV-2DNA载量,采用流式细胞计数的方法监测28例现症病人外周血具有分泌活性的Th及Tc所占比例,运用直线相关回归方法分析现症GH患者病毒载量与细胞免疫功能的相关性。结果①GH患者皮损内疱液HSV-2检出率为100%,病毒载量为(6190714±1962085)拷贝/mL。HSV-2病毒载量与患者复发次数呈显著正相关(P<0.05)。②GH组Th1、Tc1细胞数和Th1/Th2、Tc1/Tc2比值均明显低于对照组(P<0.01),而Th2细胞数显著高于对照组(P<0.01)。GH患者皮损HSV-2病毒载量与患者外周血Th1、Tc1细胞数和Th1/Th2、Tc1/Tc2比值呈显著的负相关,与Th2细胞数呈显著正相关。结论GH患者存在明显的细胞免疫功能抑制及Th、Tc细胞亚群分化失衡;GH患者的细胞免疫功能抑制可能是由于外周血T淋巴细胞亚群的变化和NK细胞减少,以及Th、Tc细胞亚群分化失衡造成,这种状态不利于机体抑制病毒复制和增殖,造成GH反复发作。

Objective To evaluate the association between virus loading in the lesion of Herpes Simplex Type 2 （HSV-2） infected area and the cell-mediated immunity in genital herpes （GH） patients. Methods HSV-2 DNA from the lesions of 28 symptomatic GH patients was measured using FQ-PCR. The proportions of Th and Tc lymphoeytes in peripheral blood were determined by flow cytometry （FCM）. Linear-regression method was used to analyze the relationship between HSV-2 DNA loading and the proportions of Th and Tc lymphocytes. Results （1） The positive detection rate of HSV-2 DNA in lesions was 100%, and the average DNA copy number was （6 190 714±1 962 085） eopies/mL. The frequency of recurrence is positively correlated with the level of HSV-2 DNA in lesions. （2）The level of HSV-2 DNA in lesion was negatively correlated with the proportions of Thl, Tcl and the ratios of Thl/Th2 and Tel/Tc2, and positively correlated with the proportion of Th2 in peripheral blood of the symptomatic GH patients.Conclusion （1） A significant suppression of cell-mediated immunity was observed in GH patients. The HSV-2 virus loads in lesions are negatively correlated with the proportions of Thl, Tcl and the ratios of Th1/Th2 and Tc1/Tc2 in peripheral blood of the GH patients. （2）The suppression of cell-mediated immunity might be caused by the shift of subsets of T lymphocytes, reduction of NK cell and the imbalance of Th and Tc differentiation, thus facilitating the virus multiplication and recurrence of GH.