CD26/DPP4对隐球菌脑膜炎患者CD4+T细胞及相关细胞因子的影响与临床意义

Affection of CD26/DPP4 on CD4+T Cells and Relative Cytokines in Patients with Crytococcal Meningitis and Its Clinical Significance

目的：分析CD26／DPP4对隐球菌脑膜炎患者CD4＋T细胞及其细胞因子的影响与临床意义。方法收集2011年8月～2015年12月在上海长海医院和长征医院确诊的36例隐球菌脑膜炎患者及36例同期健康者外周血，以密度梯度离心法分离外周血单个核细胞（PBMC），流式细胞术分选CD26＋CD4＋T，CD26－CD4＋T细胞群，反转录酶-聚合酶链锁反应（RT-PCR）检测细胞因子表达水平，以Pearson系数表示DPP4活性，CD26＋CD4＋T（％）与APACHE II评分，IL-17， TNF-α，IL-4，IFN-γ的相关性。结果实验组与对照组CD26＋CD4＋T（％）为13.35±3.83 vs 8.39±2.14，t＝6.78，P＜0.0001；DPP4活性为50.89±17.21 mU／ml vs 73.83±20.24 mU／ml，t＝5.18，P＜0.0001，差异具有统计学意义。实验组CD26＋CD4＋T（％）与 APACHE II评分，IL-17，TNF-α呈正相关（r＝0.431，0.564，0.688，P＝0.0038，0.001，0.0046）；DPP4活性与 APACHE II 评分，IL-17，TNF-α，IFN-γ呈负相关（r＝－0.544，－0.489，－0.678，－0.734；P 均＜0.001）。结论 CD26／DPP4可能通过调节Th细胞亚群参与隐球菌脑膜炎致病过程，是潜在疾病治疗靶点和预测指标。

Objective To analyze the affection and clinical significance of CD26/DPP4 on CD4＋T cells and its cytokines in patients withCrytococcalMeningitis.Methods Peripheral blood was collected from 36 patients diagnosed withCrytococcal Meningitis in Changhai Hospital and Changzheng Hospital,Shanghai from August,2011 to December,2015,meanwhile 36 health controls’was also acquired.Peripheral blood mononuclear cell （PBMC）was separated by density gradient centrifuga-tion,CD26＋CD4＋T and CD26-CD4＋T cell groups were classified by Flow Cytometry,the expression level of cytokines was tested by reverse transcriptase-polymerase chain reaction （RT-PCR）.The correlation between DPP4 activity,CD26＋CD4＋T （%）and APACHE II score,IL-17,TNF-α,IL-4,IFN-γwas measured by Pearson coefficient.Results CD26＋CD4＋T（%）between experimental and control groups was 13.35±3.83 vs 8.39±2.14 （t=6.78,P〈0.000 1）.DPP4 activity was 50.89±17.21 mU/ml vs 73.83±20.24 mU/ml （t=5.18,P〈0.000 1）,with statistically significant differences.In ex-perimental groups,CD26＋CD4＋T （%）was positively related with APACHE II score,IL-17,TNF-α（r=0.431,0.564, 0.688,P=0.003 8,0.001,0.004 6）.DPP4 activity was negatively interrelated with APACHE II score,IL-17,TNF-α,IFN-γ（r=-0.544,-0.489,-0.678,-0.734;P〈0.001）.Conclusion CD26/DPP4 may be involved in the pathogenesis of Crytococcal Meningitis through regulation of Th subgroups,and it was the potential therapeutic target and the predicted marker of the disease.