HIV/AIDS患者外周血程序性死亡受体-1的表达及临床意义

Expression of PD-1 in peripheral blood of the patients with HIV/AIDS and its clinical significance

目的探讨HIV感染及抗病毒治疗对程序性死亡受体-1(programmed death-1,PD-1)表达的影响。方法根据是否接受抗病毒治疗将61例HIV/AIDS患者分为治疗组及未治疗组,并以35例健康者作为对照。利用逆转录聚合酶链反应(RT-PCR)技术探究基因PD-1 mRNA在人外周血单个核细胞(PBMC)中的表达;通过双夹心抗体ELISA法测定血清中可溶性PD-1(sPD-1)表达水平。并比较不同CD4^+T淋巴细胞数的HIV/AIDS患者血清sPD-1的差异。结果未治疗组、治疗组、健康组研究对象PBMC中PD-1 mRNA的相对表达量均数分别为0.337 8±0.064、0.578 2±0.073和0.771 5±0.124,健康组与未治疗组差异极显著,健康组与治疗组、治疗组与未治疗组之间差异显著(P=0.031、P=0.043);未治疗组、治疗组、健康组血清sPD-1浓度分别为42.22±2.21 ng/mL、38.24±2.79 ng/mL和29.88±1.41 ng/mL。健康组与未治疗组、治疗组,治疗组与未治疗组分别具有显著性差异(P=0.008、P=0.040和P=0.020)。差异性分析结果表明,未治疗组、治疗组CD4^+T淋巴细胞数<350个/mm^3患者血清sPD-1水平均显著高于CD4^+T淋巴细胞数>350个/mm^3患者。结论抗病毒治疗在一定程度上使高水平sPD-1表达下调以促使PD-1/PD-L1通路的恢复,从而促进机体免疫重建。监测PD-1 mRNA及sPD-1的表达在HIV的辅助诊断和推断病情发展上具有一定的价值。

In order to investigate the effect of HIV infection and antiviral therapy on expression of programmed death-1 (PD-1), 61 cases of HIV / AIDS patients were divided into treatment group and untreated group,35 healthy people were taken as negative controls,expression of PD -1 mRNA were detected utilizing semi-quantitative reverse transcription and polymerase chain reaction.The levels of sPD-1 in serum were determined by enzyme linked immunosorbent assay (ELISA).The differences of serum sPD-1 in HIV / AIDS patients with different CD4 + T lymphocyte levels were also compared.The results showed that the relative expression level of PD -1 mRNA in untreated group,treatment group and healthy group were 0.337 8±0.064,0.578 2±0.073 and 0.771 5±0.124,respectively.There was significant difference between healthy group and untreated group ( P <0.001).And also significant difference were found between healthy group and treated group,treated group and untreated group,respectively ( P =0.031,P =0.043).The serum sPD-1 levels in untreated group,treatment group and healthy group were 42.22±2.21 ng/mL,38.24±2.79 ng/mL and 29.88±1.41 ng/mL,respectively.There were significant difference between the healthy group and the untreated group,the healthy group and the treated group,and between the untreated group and the treated group ( P =0.008,P =0.040,P =0.020).Moreover,the serum sPD-1 levels of CD4^+T lymphocytes <350 cells/mm^3 in untreated group and treatment group were significantly higher than those in CD4^+T lymphocyte count >350 cells / mm^3 ( P =0.035,P =0.047).In conclusion,antiviral therapy down-regulates high level sPD-1 expression to a certain extent to recovery of PD-1 / PD-L1 pathway and promote the immune reconstitution.Monitoring the expression of PD -1 mRNA and sPD-1 is of value in auxiliary diagnosis and inferred prognosis of HIV.