高效抗逆转录病毒疗法治疗24周AIDS患者Th17和Treg细胞的表达特点

Expression characteristics of Th17 and Treg cells in AIDS patients with 24 weeks highly active antiretroviral treatment

目的：观察高效抗逆转录病毒疗法（HAART）治疗24周后获得性免疫缺陷综合征（AIDS）患者辅助性17（Th17）细胞和调节性T（Treg）细胞表达水平的变化。方法选取HAART治疗的45例AIDS患者，将其按CD4＋T细胞计数分成1～100 cells/μl、101～200 cells/μl和201～350 cells/μl三组，于抗病毒前和抗病毒24周后采集静脉血，运用流式细胞仪检测外周血中CD4＋T细胞、Th17和Treg细胞的表达水平，并比较分析其相互关系。结果 AIDS患者治疗24周时Th17细胞在CD4＋T细胞中的表达频率为（1.91±0.84）%，而治疗前为（1.31±0.45）%，差异有统计学意义（t=3.67， P＜0.05）； Treg细胞表达频率在治疗24周时和治疗前分别为（5.97±0.93）%和（8.32±1.12）%，差异有统计学意义（t=3.32，P＜0.05）。治疗24周时，Th17细胞明显升高，CD4＋T细胞基数为201～350 cells/μl患者组其Th17细胞表达频率显著高于101～200 cells/μl和1～100 cells/μl组患者（t分别=2.68、4.51，P均＜0.05）。 Treg细胞表达频率经治疗后显著下降，CD4＋T细胞基数为201～350 cells/μl组患者Treg细胞表达频率下调程度显著高于101～200 cells/μl和1～100 cells/μl组患者（t分别=2.47、3.89，P均＜0.05）。治疗前CD4＋T细胞数与Th17表达的百分率呈正相关（r=0.48， P＜0.05），与Treg表达的百分率呈负相关（r=-0.30，P＜0.05）。结论 AIDS患者Th17表达水平下降，Treg表达则上升；HAART治疗能有效地上调Th17表达频率，下调Treg细胞水平；CD4＋T细胞基数高的患者较基数低的患者对抗病毒治疗其免疫反应更有效，提示Th17和Treg细胞表达频率可作为HAART治疗有效性的一项判断依据。

Objective To observe the expression levels of Th17 and Treg cells of acquired immune deficiency syn-drome（AIDS） suffered patients after 24 weeks highly active antiretroviral treatment（HAART）. Methods According to the CD4＋T cell amounts , 45 AIDS patients received HAART treatment were divided into three groups. Flow cytometry technol-ogy was used to detect the CD4＋T Cells count, Treg and Th17 cells in peripheral blood at the time of pre-therapy and 24 weeks. Results The ratio of Th17 cells in AIDS patients was （1.91±0.84）%in 24 weeks, and was （1.31±0.45）% at the time of pre-therapy, the difference was significant（t=3.67, P〈0.05）. The expression level of Treg was （5.97±0.93）%and （8.32±1.12） % at the time of 24 weeks treatment and pre-therapy with statistical significance （t=3.32,P〈0.05）. Th17 cells expression level was raised after 24 weeks, and which of CD4＋T cells for 201~350 cells/μl group showed a remarkable decline than those of CD4＋T cells for 101~200 cells/μl and 1~100 cells/μl groups （t=2.68,4.51,P〈0.05）.Treg cells ex-pression level were down-regulated after 24 weeks treatment, and the dropped levels with of CD4＋ T cells for 201~350cells/μl group was higher than those of two other groups（t=2.47,3.89,P〈0.05）. Th17 cells was significantly positively related to the percentage of CD4＋T cells count（r=0.48, P〈0.05）;the correlation of Treg expression and CD4＋T Cells count was significantly negative（r=-0.30, P〈0.05） at the time of pre-therapy. Conclusions The expression level of Th17 cells decreased,while Treg cells was increased in AIDS patients; HAART treatment could upregulated Th17 cells level and downregulated Treg cells. The patients with higher baseline of CD4＋T cells has higher immune reaction effective than that of the lower baseline CD4＋T cells. The Th17 and Treg cells are likely to be the effective indexes to observe HAART progress.