HAART早期AIDS患者CD4^+CD25^+Foxp3^+调节性T细胞的变化及其与免疫活化关系的研究

Relationship between CD4^+ CD25^+ Foxp3^+ Regulatory T Cells and Immune Activation in AIDS Patients Undergoing Early Highly Active Anti-retroviral Therapy

目的了解高效抗反转录病毒联合疗法(highly active antiretroviral the rapy,HAART)早期AIDS患者CD4+CD25+Foxp3+调节性T细胞(regulatory Tcell,Treg)的变化规律,探讨抗病毒治疗过程中Treg细胞的作用。方法前瞻性分析21例接受HAART规律治疗的AIDS患者,收集患者服药前及服药第2、4、8、12周时的静脉血,采用流式细胞仪胞内染色技术检测CD4+CD25+Foxp3+调节性T细胞的水平,分析Treg细胞在治疗过程中的变化规律,以及Treg细胞的变化与免疫活化间的相关性。结果 HAART治疗开始,Treg细胞计数呈逐渐上升的趋势,前4周呈现快速上升,而后上升速度减慢,Treg百分比变化也有相似的规律;CD8+CD38+表达水平随治疗时间延长而下降,未治疗时Treg细胞计数与免疫活化水平呈负相关,治疗后Treg细胞计数4周内的变化与12周CD8+CD38+水平呈负相关,即治疗开始后,前4周内Treg细胞增加越明显,治疗3个月时免疫活化水平下降越明显。结论抗病毒治疗过程中,活化CD8+淋巴细胞比例的下降与外周血中Treg细胞数的增加相关。Treg细胞数量恢复越早,活化CD8+淋巴细胞比例下降越明显。

Objective To understand the variation of the CD4＋CD25＋Foxp3＋ regulatory T cells in HIV-infected patients during early highly active anti-retroviral therapy（HAART） and the function of Treg cells during antiviral therapy.Methods Data of 21 HIV-infected patients undergoing HAART were analyzed in this study.This was a prospective study which enrolled treatment-naive HIV-infected patients just prior to starting HAART;levels of Treg were measured by flow cytometry at weeks 0,2,4,8,12 of treatment.The relationship between Treg cells and immunologic activation was studied.Results Treg cell counts were higher when treatment with HAART was started,especially during first 4 weeks,then the trend was slowed down,so was the ratio of Treg.As HAART went on,the expression of CD8＋CD38＋ was reduced.The Treg counts was inversely correlated with immune activation level for treatment-naive patients.Conclusion The declined ratio of activated CD8＋ may be related to the number of elevated Treg cells.The earlier the Treg cells resumed,the more the proportion of activated CD8＋ T cells declined.