HIV-1急性期感染者肠道归巢CD4^+T淋巴细胞的变化特点

Characterization of gut-homingα 4β7CD4^+T cells in acute HIV-1-infected individuals

目的分析Ⅰ型艾滋病病毒（HIV-1）急性期感染者肠道归巢CD4~＋T淋巴细胞（简称CD4细胞）的变化特点及在HIV-1致病机制中的作用。方法共纳入26例HIV-1急性期感染者、31例HIV-1慢性期感染者和20例健康对照者。采用流式细胞仪检测三组样本的肠道归巢CD4细胞的比例和数量,并分析HIV-1急性期感染者肠道归巢CD4细胞与CD4细胞之间的相关性。结果与健康对照者相比,HIV-1急性期感染者肠道归巢CD4细胞的比例（平均值13.5%vs 11.0%,P〈0.05）和数量（平均值88.1vs 61.9,P〈0.01）均显著减少。HIV-1慢性期感染者肠道归巢CD4细胞的比例（平均值11.0%vs 8.1%,P〈0.01）和数量（平均值61.9vs 11.9,P〈0.000 1）均显著低于HIV-1急性期感染者。HIV-1急性期感染者肠道归巢CD4细胞的数量与外周血CD4细胞（r=0.53,P=0.006）和CD4/CD8细胞比例（r=0.51,P=0.009）呈显著正相关,与血浆中HIV-1病毒载量（r=-0.70,P=0.000 6）和机体T细胞免疫活化水平（r=-0.57,P=0.003）呈显著负相关。结论肠道归巢CD4细胞的丢失可能在HIV-1急性期感染的致病机制中起作用。

Objective To analyze the changes of gut-homing CD4~＋T cells in acute HIV-1-infected individuals（AHIs）.Methods 26 AHI,31 chronic HIV-1-infected patients（CHIs）,and 20 healthy controls（HCs）were enrolled in this study.Flow cytometry was performed to analyze the frequency and absolute number of gut-homing CD4~＋T cells among three groups.Correlation between gut-homing CD4~＋T cells and CD4~＋T cell count were also analyzed in AHIs.Results Compared with HCs,gut-homing CD4~＋T cells were significantly decreased in both frequency（mean 13.5% vs 11.0%,P〈0.05）and absolute numbers（mean 88.1 vs 61.9,P〈0.01）in AHIs.Guthoming CD4~＋T cells in CHIs were also lower than those in AHIs（mean frequency 11.0% vs 8.1%,P〈0.01,mean count 61.9 vs 11.9,P0.0001）.Correlation analysis revealed that the decrease of gut-homing CD4~＋T cells in AHIs was positively correlated with the loss of CD4~＋T cells（r=0.53,P=0.006）and CD4/CD8 ratio（r=0.51,P=0.009）,and negatively correlated with plasma HIV-1 viral load（r=-0.70,P=0.0006）and the level of T cell immune activation（r=-0.57,P=0.003）.Conclusion Gut-homing CD4~＋T cells may contribute to the HIV-1 pathogenesis in acute infection stage.