梅毒患者外周血程序性死亡分子1的表达水平及临床价值研究

Study on the expression level and clinical value of programmed death-1 in peripheral blood of syphilis patients

目的分析梅毒患者外周血程序性死亡分子1(PD-1)的表达水平及临床价值。方法将2018年6月至2019年6月在该院就诊的60例梅毒患者纳入梅毒组,另选取同期该院30例体检健康志愿者作为对照组。采用酶联免疫吸附试验(ELISA)法检测外周血PD-1水平,比较2组外周血PD-1水平及不同临床特征的梅毒患者外周血PD-1水平。采用Spearman相关性分析外周血PD-1与梅毒患者临床特征的相关性。采用流式细胞术检测外周血CD4^+CD25^+hight调节性T细胞(Treg)、CD4^+CD25^+low Treg、CD4^+CD25^+low Treg/CD4^+CD25^+hight Treg及其细胞表面上的PD-1水平。结果梅毒组外周血PD-1水平显著高于对照组(P<0.05);不同性别、年龄的梅毒患者外周血PD-1水平比较,差异无统计学意义(P>0.05);但梅毒快速血浆反应试验(RPR)滴度为1∶8患者外周血PD-1水平显著高于1∶1、1∶2、1∶4患者,临床分期Ⅱ期患者外周血PD-1水平显著高于Ⅰ期患者(P<0.05)。Spearman相关分析结果显示,外周血PD-1与RPR滴度、临床分期呈正相关(r=0.659、0.433,P<0.01)。梅毒组外周血CD4^+CD25^+hight Treg、PD-1+/CD4^+CD25^+hight Treg、PD-1+/CD4^+CD25^+low Treg细胞高于对照组,CD4^+CD25^+low Treg/CD4^+CD25^+hight Treg显著低于对照组(P<0.05)。结论梅毒患者外周血PD-1存在高表达现象,且表达水平与病情密切相关。

Objective To analyze the expression level and clinical value of programmed death-1(PD-1)in peripheral blood of syphilis patients.Methods Totally 60 syphilis patients treated in the hospital from June 2018 to June 2019 were included in the syphilis group,and 30 healthy volunteers during the same period were selected as the control group.The level of PD-1 in peripheral blood was detected by enzyme-linked immunosorbent assay(ELISA).The level of PD-1 in peripheral blood between the two groups and the level of PD-1 in peripheral blood of syphilis patients with different clinical characteristics were compared.The correlation between PD-1 in peripheral blood and the clinical characteristics of syphilis patients was analyzed by Spearman correlation.The levels of CD4^+CD25^+hight Treg,CD4^+CD25^+low Treg and CD4^+CD25^+low Treg/CD4^+CD25^+hight Treg in peripheral blood,and PD-1 level in cells were detected by flow cytometry.Results The level of PD-1 in syphilis group was significantly higher than that in control group(P<0.05).There was no significant difference in the level of PD-1 in peripheral blood of syphilis patients of different genders and ages(P>0.05).However,the level of PD-1 in peripheral blood of patients with 1∶8 RPR titer was significantly higher than that of patients with 1∶1,1∶2,1∶4,the level of PD-1 in peripheral blood of patients with clinical stageⅡwas significantly higher than that of patients with stageⅠ(P<0.05).Spearman correlation analysis showed that PD-1 in peripheral blood was significantly positively correlated with RPR titer and clinical staging(r=0.659,0.433,P<0.01).CD4^+CD25^+hight Treg,PD-1+/CD4^+CD25^+hight Treg and PD-1+/CD4^+CD25^+low Treg cells in peripheral blood of syphilis patients were significantly higher than those of control group,while CD4^+CD25^+low Treg/CD4^+CD25^+hight Treg was significantly lower than that of control group(P<0.05).Conclusion The soluble PD-1 is highly expressed in peripheral blood of syphilis patients,and the expression level is closely related to disease.