HIV-1感染者TFH细胞的特点及临床意义

Characteristics and clinical significance of cellular immunity indices of TFH cells in HIV-1 infected patients

目的研究HIV-1感染者外周血CXCR5^+CD4^+T细胞(TFH)的特点及其与艾滋病(AIDS)进展的关系。方法本研究入组17例健康对照和65例HIV-1感染者,HIV-1感染者包括抗病毒治疗前患者48例、抗病毒治疗17例,其中抗病毒治疗前患者又分为CD4^+T细胞≤200个/μl者9例、200个/μl<CD4^+T细胞≤350个/μl者19例和CD4^+T细胞>350个/μl者20例。通过流式细胞技术检测健康对照和HIV-1感染者外周血CD4^+T细胞表面CXCR5分子的表达,并将HIV-1感染者TFH细胞百分比与CD4/CD8比值和HIV-1病毒载量进行相关性分析,对HIV-1感染者TFH细胞百分比、绝对计数与TFC细胞进行相关性分析。结果与健康对照组比较,HIV-1抗病毒治疗前组患者外周血TFH细胞百分比[(18.83±4.55)%vs.(22.06±5.35)%,U=242.00,P=0.0124)和绝对数[(60.23±27.62)个/μlvs.(207.53±51.50)个/μl,U=0,P<0.0001]明显降低;抗病毒治疗组TFH细胞绝对数明显高于抗病毒治疗前组[(135.05±60.77)个/μl vs.(60.23±27.62)个/μl,U=108.00,P=0.0082]。抗病毒治疗前组外周血TFH细胞百分比与CD4/CD8比值呈负相关(r=–0.338,P=0.019),与血浆病毒载量呈正相关(r=0.392,P=0.006)。TFH细胞百分比(r=0.363,P=0.011)和绝对数(r=0.408,P=0.004)与TFC细胞百分比均呈正相关。在抗病毒治疗前组中,随着CD4^+T细胞减少TFH细胞百分比下降,TFH细胞的绝对数呈增加趋势。结论 HIV-1感染者外周血TFH细胞与AIDS进展相关,TFH细胞的减少可能与外周血TFC细胞的清除杀伤作用有关。

Objective To study the correlation between follicular helper T (TFH) cells with the cellular immunity indices and the percentage of follicular cytotoxic T (TFC) cells in peripheral blood of human immunodeficiency virus-1 (HIV-1) infected patients and explore the relationship between TFH cells and the acquired immunodeficiency symdrome (AIDS) disease progression. Methods Seventeen health controls and 65 HIV-1 infected individuals were enrolled in this study, and the HIV-1 infected patients included 48 untreated HIV-1 positive patients and 17 treated with highly active antiretroviral therapy, the 48 HIV-1 infected patients consisted of 9 patients with CD4+ T cells ≤200/μl, 19 with 200/μl <CD4+ T cells ≤350/μl and 20 with CD4+ T cells >350/μl. The expression of CXCR5 on CD4+ T cells was detected by flow cytometry and its correlation with CD4/CD8 ratio and HIV-1 RNA viral load. We also analyzed the correlation between the percentage and absolute number of TFH cells and TFC cells. Results Compared with healthy controls, both the absolute cell numbers [(60.23±27.62)/μl vs.(207.53±51.50)/μl, U=0, P<0.0001] and frequency [(18.83±4.55)% vs.(22.06±5.35)%, U=242.00, P=0.0124] of TFH cells were significantly reduced in untreated HIV-1 infected patients;The absolute number of TFH cells in the antiretroviral therapy group was significantly higher than that in untreated HIV-1 infected patients [(135.05±60.77)/μl vs.(60.23±27.62)/μl, U=108.00, P=0.0082]. The frequency of TFH cells in untreated HIV-1 infected patients were negatively correlated with CD4/CD8 ratio (r=-0.338, P=0.019), positively correlated with viral load (r=0.392, P=0.006). Both the absolute cell numbers (r=0.408, P=0.004), and frequency (r=0.363, P=0.011) of TFH cells were positively correlated with the frequency of TFC cells. The percentage of TFH cells decreased with the decrease of CD4+ T cells and the number of TFH cells increased with the decrease of CD4+ T cells in untreated HIV-1 infected patients. Conclusions TFH cells may be associated with active replication of the HIV-1 and disease progression. The decrease of TFH absolute cell numbers in patients with HIV-1 infection may be related to the cytotoxicity of TFC cells.