慢性HIV／AIDS患者T淋巴细胞凋亡与疾病进展关系的研究

A study on T lymphocyte apoptosis and disease progression in chronic HIV/AIDS patients

目的探讨慢性未经抗病毒治疗的HIV／AIDS患者T淋巴细胞及各亚群凋亡与疾病进展的相关性。方法以36例慢性未经抗病毒治疗的HIV／AIDS患者为研究对象，根据CIM细胞计数分为3组：〈200个／μl组，200～350个／μl组，〉350个／μl组，同时选取16例健康志愿者作对照，分离外周血单核细胞（PBMC）后，采用C1M5RO及CD27标记T细胞亚群，AnnexinV标记细胞凋产，用流式细胞仪检测各项指标。其中4例患者及4例健康志愿者的PBMC在体外培养，比较分析体外培养0、3、6、12、24h不同时间点T细胞凋亡的变化情况。结果（1）HIV／AIDS患者CD4^＋、CD8^＋T细胞及各亚群上AnnexinV表达百分比均显著高于健康人（P〈0．05），但3组患者之间比较差异无统计学意义（P〉0．05）；（2）HIV／AIDS患者CD4^＋、CD8^＋T细胞及各亚群上AnnexinV表达百分比与CD4^＋T细胞计数及病毒载量均无显著相关性（P〉0．05）；（3）随着体外细胞培养时间的延长，HIV／AIDS患者CD4^＋T细胞的凋亡及死亡细胞百分比均显著高于健康人（P〈0．05），并且HIV／A1DS患者CD4^＋T细胞较CD8^＋T细胞更易发生凋亡和死亡。结论HIV／AIDS患者的T细胞凋亡水平显著高于健康人，并且CD4^＋T细胞较CD8^＋T细胞更易发生凋亡和死亡，但是T细胞凋亡水平与HIV的疾病进展程度并没有相关性。

Objective To discuss the relationship between various T lymphocyte subsets apoptosis and disease progression in chronic antiretroviral-naive HIV/AIDS patients. Methods Thirty-six chronic antiretroviral-naive HIV-infeeted individuals as well as 16 healthy HIV-negative controls were performed in this study. According to the CD4^＋ T cell counts, all the patients were divided three groups： 〈 200μl, 200-350μl and 〉 350μl. After the peripheral blood mononuclear cells （PBMC） were isolated, T lymphocyte subpopulations were determined by the expression of CD45RO and CD27, and the apoptosis of different T cell subsets were measured by Annexin V staining, then analyzed by flow cytometry. To investigate whether the apoptosis of T cells varied with the culture time in vitro, 4 healthy controls and 4 patients were chosen as subjects, and the levels of cell apoptosis were analyzed at the culture time points of 0, 3, 6, 12, 24 h. Results （ 1 ） The percenta- ges of the AnnexinV expression on CD4^＋ and CD8 ^＋ T cells and all the subsets in HIV/AIDS patients were significantly higher than that in the healthy controls（ P 〈 0.05）, but there were no significant differences among the three HIV-infected patient groups（P 〉 0.05）. （2） No significaut con＇elations were observed between the levels of apoptosis of all the T cells and subsets and total CD4^＋ T ceil counts （ P 〉 0.05 ） , nor with the HIV viral load （ P 〉 0.05）. （3） As the culture time prolonged in vitro, the levels of apoptosis and necrosis of CD4^＋ T cells in HIV/AIDS patients were significantly higher than those in the healthy controls, and the CD4^＋ T cells were more susceptible to apoptosis and necrosis compared with CD8^＋ T cells. Conclusion The levels of T cell apoptosis in HIV/AIDS patients was significantly higher than those in the healthy controls, at the same time, CD4^＋ T cells were more susceptible to apoptosis and necrosis compared with CD8^＋ T cells, but no correlation was found between the T cell apoptsis and disease progression.