卡介菌多糖核酸对尖锐湿疣患者外周血TCRγδ^＋T细胞的影响及临床疗效

Effect of polysaccharide nucleic acid fraction of Bacillus Calmette-Guerin on TCRγδ^＋ T lymphocytes in peripheral blood of patients with condylomata acuminata

目的研究卡介菌多糖核酸（BCG-PSN）对尖锐湿疣（CA）患者外周血T细胞受体（TCR）γδ^＋T细胞的影响及临床疗效。方法采用流式细胞仪检测了20例正常对照者和60例CA患者（BCG-PSN组40例和病例对照组20例）治疗前后外周血CD3^＋T、TCRγδ^＋T和TCRαβ^＋T细胞进行了检测；并对BCG-PSN治疗CA的临床疗效进行了分析。结果治疗前CA患者外周血CD3^＋T、TCRγδ^＋T细胞百分率低于正常对照（47.64±7．19vs68．92±6.15，t=12．00；2.27±0．68vs4.65±0．99，t=12．17；P〈0，01）；TCRαβ^＋T细胞百分率与正常对照组相比差异无统计学意义（23．55±4.71vs25．09±5．30，t=1.24，P〉0．05）。治疗后BCG-PSN组患者外周血CD3^＋T、TCRγδ^＋T、TCRαβ^＋T细胞百分率明显升高（70．21±9．64vs47、62±7.91，35.55±4.77vs23，54±4．71，4．52±1．21vs2．25±0．68，P〈0．01）；病例对照组无显著变化（P〉0．05）；BCG-PSN组与病例对照组治疗前后CD3^＋T、TCRγδ^＋T、TCRαβ^＋T细胞百分率差值比较，差异有统计学意义（P〈0．01）。临床观察证荚BCG—PSN能够显著提高CA临床治愈率，降低CA的复发率。结论CA患者存在TCRγδ^＋T细胞缺陷；BCG—PSN可提高CA患者的TCRγδ^＋T细胞百分率，从而加强患者的T细胞免疫功能，以提高其临床疗效、减少其复发。

Objective To investigate the effects of polysaccharide nucleic acid fraction of bacillus calemette guerin （BCG-PSN） on TCRγδ^＋T lymphocytes in patients with condyloma acuminatum （CA）, and evaluate the effectiveness of BCG-PSN in the treatment of CA. Methods Flow cytometric analysis was employed to study CD3^＋ T, TCRγδ^＋ T and TCRαβ^＋ T lymphocytes in peripheral blood of 60 patients with CA （before and after treatment 40 patients treated with BCG-PSN, 20 patients treated without BCG-PSN） and 20 healthy controls. Results Before treatment, the percentage of CD3^＋ T and TCRγδ^＋ T lymphocytes were significantly lower （47. 64 ± 7. 19 vs 68. 92 ± 6. 15, t = 12.00 ; 2. 27 ±0. 68 vs 4. 65 ± 0. 99, t = 12. 17 ; P 〈 0. 01 ）, while the percentage of TCRαβ^＋ T lymphocytes had no significant change （ 23. 55 ± 4. 71 vs 25.09 ±5.30, t = 1.24, P 〉 0. 05 ）. The percentage of CD3^＋ T, TCRγδ^＋ T and TCRαβ^＋ T lymphocytes were significantly increased （70. 21 ± 9. 64 vs 47.62 ± 7.91,35.55 ± 4. 77 vs 23. 54 ± 4.71,4. 52 ± 1.21 vs 2. 25 ± 0. 68, P 〈 0. 01 ） in CA patients after treatment with BCG-PSN. The percentage of CD3^＋T, TCRγδ^＋ T and TCRαβ^＋ T lymphocytes were not significantly changed in healthy control group before and after treatment （ P 〉 0. 05 ） ; The changes of the percentage of CD3^＋T, TCRγδ^＋ T and TCRαβ^＋T lymphocytes before and after treatment in the BCG-PSN group were higher than that in the healthy control group. Clinical observations confirmed that the BCG- PSN treatment can significantly increase the clinical cure rate and decrease the recurrent rate. Conclusion There are impaired TCRγδ^＋T lymphocyte in the peripheral blood of CA patients. BCG-PSN can effectively upregulate the level of TCRγδ^＋ T lymphocyte in CA patients. BCG-PSN treatment can significantly increase the clinical cure rate and decrease the recurrent rate in CA patients.