HIV阳性患者感染急性间日疟的细胞因子反应

Cytokine responese of HIV-positive patients to acute Plasmodium vivax malaria

目的 探讨疟疾疗法 (治疗性急性间日疟 )治疗HIV感染的部分机制。方法 12例HIV 1感染者 (CD4细胞水平为 12 17～ 15× 10 6/L)接受疟疾疗法 ,按CD4细胞水平高低编号和分组 :例 1～ 12为总组 (TG) ,例 1～ 5 (CD4>5 0 0× 10 6/L)为第一亚组 (SG1) ,例 6～ 10 (CD4为 499～ 2 0 0× 10 6/L)为第二亚组 (SG2 ) ,例 11～ 12 (CD4<2 0 0× 10 6/L)不列入亚组作统计学分析。用ELISA法检测血浆细胞因子和细胞因子活性标记物。结果 从总体 (TG组 )上看 ,在疟疾期 ,血浆TNF α、sTNF RII、sIL 2R、新喋呤 (NPT)和 β 2微球蛋白 (β2M ,只有部分患者检测 )均显著升高 ,SG2组显著高于SG1组。但终止疟疾后这些因子迅速降至疟疾感染前的基线水平。在所有患者中IFN γ均检测不到。结论 疟疾疗法治疗HIV感染的部分机制是激发患者体内产生多种细胞因子 ,使已经失去平衡的免疫系统得到一次调整 ,达到一种新的免疫平衡。

Objective To explore the mechanism of malariotherapy (therapeutic acute Plasmodium vivax malaria) for HIV infection. Methods Total 12 HIV-1 infected patients with CD4 cell count baseline levels at 1217～15×10 6/L were included, patients were grouped according to CD4 counting. Case 1～12 were as the total group (TG), case 1～5 as sub-group1(SG1, CD4>500×10 6/L), case 6～10 as sub-group2(SG2, CD4 at 499～200×10 6/L), case 11～12 (CD4<200×10 6/L) were not as a sub-group for statistic analysis. ELISA was used to measure plasma levels of cytokines and activation markers. Results In TG, plasma levels of TNF-α,sTNF-RII,sIL-2R, neopterin (NPT) and β-2-microglobulin (β2M, only some patients were tested) significantly increased during malarial phase, but sharply declined to baseline levels after malaria ended. Interestingly, significantly higher levels of these factors were seen in SG2 than in SG1 during malarial phase. IFN-γ was undetectable in all patients.Conclusions One of the mechanisms of malariotherapy for HIV is to induce a variety of cytokines. These cytokines act on the unbalanced immune system, resulting in a new balance.