艾滋病患者程序性死亡受体-1和配体表达变化与疾病进展的相关性研究

Expression level of programmed death receptor-1 and ligand in AIDS patients and its correlation between B7-H1/PD-1 and AIDS progression

目的了解艾滋病(AIDS)患者及人类免疫缺陷病毒(HIV)感染者外周血中的程序性死亡受体-1(PD-1)和配体(PD-L1/B7-H1)的表达水平,分析B7-H1/PD-1表达水平与外周血CD4+T淋巴细胞计数、疾病进展的相关性,探讨其在HIV/AIDS发病中的作用。方法选择2010年1月-2012年12月医院传染科、艾滋病门诊和疾病预防控制中心就诊的HIV、AIDS患者,依据CD4+T细胞数减少<50copies/μl的患者为疾病稳定组,≥50copies/μl的患者为疾病进展组,将15例AIDS患者和21例HIV感染者分为疾病稳定组和疾病进展组,运用流式细胞术检测其外周血中CD4+T细胞上的B7-H1/PD-1的表达频率,并与21名健康对照组比较,所有资料采用SPSS17.0软件进行统计分析。结果 PD-1与B7-H1的表达率AIDS患者为(1.21±0.25)%与(0.57±0.20)%,显著高于HIV患者的(1.08±0.17)%与(0.41±0.17)%,差异有统计学意义(P<0.01),HIV患者PD-1和B7-H1表达水平明显高于健康对照者的(0.57±0.14)%与(0.19±0.09)%,差异有统计学意义(P<0.01);外周血中PD-1表达频率疾病进展组患者为(1.17±0.25)%,疾病稳定组为(0.94±0.21)%,两者差异有统计学意义(P<0.01);B7-H1在疾病进展组和稳定组中的表达频率分别为(0.51±0.20)%和(0.37±0.19)%,两组比较差异有统计学意义(P<0.5);HIV/AIDS患者CD4+T细胞数与PD-1和B7-H1的表达水平呈显著负相关(P<0.01),病毒载量与PD-1和B7-H1的表达水平呈显著正相关(P<0.01)。结论不同疾病进展阶段的HIV/AIDS患者B7-H1和PD-1表达水平显著不同,随着疾病的进展,B7-H1和PD-1的表达水平升高。

OBJECTIVE To learn the expression levels of programmed death receptor-1（PD-1）and programmed cell death ligand（PD-L1 /B7-H1） expression levels of HIV/AIDS patients in China and find the correlation between the expression levels of B7-H1/PD-1and CD4 ＋ T lymphocyte and disease progression ,and to discuss the relevance of B7-H1/PD-1 with HIV/AIDS pathogenesis .METHODS According to the change of CD4 ＋ T cell counts ,21 cases of HIV infected people and 15 cases of AIDS patients received by the hospital and the centers for disease control and prevention from Jan .2010 to Dec .2012 were divided into stable disease group and disease progression group（during 2 years′study period ,the reduction in the number of CD4 ＋ T cells 〈 50 copies/μl for stable disease group , ≥ 50 copies/μl for disease progression group） . The flow cytometry was used to detect expression frequency of B7-H1/PD-1 of the two groups and the 21 cases of healthy controls .Data were processed with SPSS17 .0 .RESULTS AIDS patients′expression percentage of PD-1 and B7-H1 were （1 .21 ± 0 .25）% and（0 .57 ± 0 .20）% respectively ,significantly higher than those of HIV patients （（1 .08 ± 0 .17）% and（0 .41 ± 0 .17）% , respectively P〈0 .01） .HIV patients′expression level of PD-1 and B7-H1 were significantly higher than those of the healthy control group（（0 .57 ± 0 .14）% and （0 .19 ± 0 .09）% ;P〈 0 .01） .In the peripheral blood ,the expression level of PD-1 in the disease progression group patients was 1 .17 ± 0 .25% ,while the stable disease group was （0 .94 ± 0 .21）% ,and two groups had significant difference （P〈 0 .01） .B7-H1 frequency in the disease progression group and stable disease group were respectively（0 .37 ± 0 .19% ）and （0 .51 ± 0 .20）% ,and two groups had significant difference （P〈 0 .05） .In HIV/AIDS patients ,CD4 ＋ T cell count was significantly negatively correlated with the expression level of PD-1 and B7- H1 （P〈 0 .01） .Viral load was significantly positively correlated with the expression level of PD-1 and B7-H1 （P〈 0 .01） .CONCLUSION The B7- H1 and PD-1 levels are different between HIV/AIDS patients in different disease stages ,and B7-H1 and PD-1 levels increase with the disease progression .