HIV感染合并肺部感染患者 CD3+CD4+-T细胞表达的研究

Expression of CD3+CD4+-T cells in patients with human immunodeficiency virus infection complicated with pulmonary infection

目的探讨α干扰素(Interferon-α,IFN-α)、干扰素诱导基因56(Interferon-stimulated gene 56,ISG56)、粘病毒抵抗蛋白A(Myxovirus resistance protein A,MxA)、免疫调控受体程序性死亡分子1(Programmed death-1,PD-1)和T细胞免疫球蛋白及免疫酪氨酸样抑制基序(T cell immunoglobulin and ITIM domain,TIGIT)对人类免疫缺陷病毒(Human immunodeficiency virus,HIV)合并肺部感染患者CD3^+CD4^+-T细胞表达的影响。方法选取2016年12月-2017年12月于余姚市市人民医院就诊的52例HIV合并肺部感染患者作为研究组进行研究,另选择同期48例HIV未合并肺部感染患者作为对照组,检测患者外周血CD3^+CD4^+-T细胞表面的IFN-α、ISG56、MxA、PD-1和TIGIT指标水平情况。结果研究组CD3^+CD4^+-T细胞比例高于对照组(P<0.05);研究组IFN-α、ISG56、MxA分别为(15.82±5.31)、(0.74±0.22)、(0.83±0.14)pg/ml低于对照组(P<0.001);研究组TIGIT和PD-1的CD3^+CD4^+-T细胞分别为(23.61±12.83)%、(51.32±13.74)%高于对照组(P<0.05);研究组TIGIT CD3^+CD4^+-T细胞表面百分数与CD4+-T细胞绝对数呈负相关(P=0.027);与病毒载量呈正相关(P=0.001);研究组PD-1CD3^+CD4^+-T细胞表面百分数与CD4+-T细胞绝对数呈负相关(P=0.026);与病毒载量无相关性(P=0.711)。结论HIV合并肺部感染患者,CD3^+CD4^+-T细胞占比上升,IFN-α、ISG56、MxA降低,TIGIT和PD-1升高,相关指标变化证明当受到感染时机体免疫功能会发生紊乱,且与HIV疾病进展具有一定程度的相关性,具有一定的临床价值。

OBJECTIVE To investigate the expression of interferon-alpha(IFN-alpha),interferon-stimulated gene 56(ISG56),myxovirus resistance protein A(MxA),programmed cell death protein-1(PD-1)and T cell immunoglobulin and ITIM domain(TIGIT)in patients with human immunodeficiency virus(HIV)complicated with the lung infection.METHODS Totally 52HIV patients with pulmonary infection treated in Yuyao People's Hospital from Dec.2016to Dec.2017were selected as the study group.Another 48HIV patients without pulmonary infection were selected as the control group.The levels of IFN-α,ISG56,MxA,PD-1and TIGIT on the surface of CD3^+CD4^+-T cells in peripheral blood were measured.RESULTS The percentage of CD3^+CD4^+-T cells in the study group was significantly higher than that in the control group(P<0.05).The levels of IFN-a,ISG56and MxA in the study group was(15.82±5.31),(0.74±0.22),(0.83±0.14)pg/ml,significantly lower than those in the control group(P<0.05).The percentages of TIGIT and PD1CD3^+CD4^+-T cells in the study group were(23.61±12.83)and(51.32±13.74),significantly higher than those in the control group(P<0.05).The percentage of TIGIT and PD-1CD3^+CD4^+-T cells in the study group was negatively correlated with the absolute number of CD4+-T cells(P=0.027),and positively correlated with viral load(P=0.001).The percentage of PD1CD3^+CD4^+-T cells in the study group was negatively correlated with the absolute number of CD4+-T cells(P=0.026)and not correlated with viral load(P=0.711).CONCLUSIONIn patients with HIV combined with pulmonary infection,the proportion of CD3^+CD4^+-T cells increased,IFN-α,ISG56,MxA decreased,TIGIT and PD-1increased obviously.The changes of related indexes showed that the immune function of the body became disordered when infected,and it had some correlation with the progression of HIV disease,with certain clinical value.