肾综合征出血热CD178^＋T淋巴细胞本质的临床研究

A clinical study on CD_(178)positive T lymphocyte in hemorrhagic fever with renal syndrome

目的探讨肾综合征出血热(hemorrhagicfeverwithrenalsyndrome,HFRS)患者CD178+T淋巴细胞的本质及其在致病过程中的作用。方法应用流式细胞仪(flowcytometry,FCM)对56份HFRS患者外周血标本进行检测,分析CD178在HFRS淋巴细胞亚群和活化淋巴细胞中的表达及其动态变化。结果HFRS发热期和多尿期CD4+CD178+及CD8+CD178+T淋巴细胞与对照组比较明显增加,差异具有统计学意义。HFRS发热期和多尿期CD178在CD4+HLADR+T淋巴细胞群及CD8+HLADR+T淋巴细胞群表达均明显增高,与正常对照组比较,差异具有统计学意义;而发热期与多尿期之间比较,差异无统计学意义。结论HFRS的发病过程中CD178表达于活化CD4+淋巴细胞亚群,主要表达于CD8+T细胞亚群,且病程早期和后期均有高表达。推测在发病早期细胞毒T细胞(cytotoxicTlymphocyte,CTL)通过CD178介导的细胞调亡清除病毒感染的靶细胞,在疾病末期则通过清除活化的抗原特异性T细胞,维持机体免疫自身的稳定。

Objective To further probe into the role of CD178 in the pathogenesis of hemorrhagic fever with renal syndrome （HFRS）. Method The expression of CD178 and HLA-DR on T cell subsets in peripheral blood of patients with HFRS and their dynamic changes were detected by Flow cytometry. Results CD4^＋ CD178^＋ and CD8^＋ CD178^＋ T lymphocytes both in fever and polyuria phases were significantly higher than those in normal controls, while there was no significant difference between the both phases of HFRS （P 〉 0. 05 ）. CD178 expression on CD4^＋ HLA-DR^＋ and CD8^＋ HLA-DR^＋ T lymphocytes were significantly higher than those in normal controls （P 〈0.05, P 〈0.01, P 〈0. 001, P 〈0. 001 ）, while there was no significant difference between CD4^＋ HLA-DR^＋ and CD8^＋ HLA-DR^＋ T lymphocytes （ P 〉 0. 05 ）. Conclusion CD178 was expressed on both CD4^＋ and CD8^＋ T cell subsets, but mainly on CD8^＋ T cell subsets both in early stage and in later stage in the pathogenesis of HFRS. Cytotoxic T lymphocyte（CTL） might kill target cells infected by hantavirus （HV） and eliminate HV via cell apoptosis mediated by CD178 in early stage of HFRS. In later stage of HFRS, CD178 might reduce antigen-specific T lymphocytes by activation induced cell death（AICD） and help to maintain the homeostasis of immune system.