艾滋病患者血清CXCL8、FOXP3的表达及临床意义

The expression and clinical significance of serum CXCL8 and FOXP3 in AIDS patients

目的探讨趋化因子8(CXCL8)、叉头状转录因子P3(FOXP3)在艾滋病患者血清中的表达及临床意义。方法选取2018年5月—2021年5月郑州市疾病预防控制中心收治的72例艾滋病患者为艾滋组,选取同期到本中心体检且与患者一般资料匹配的健康人群60例为对照组。收集一般资料,比较两组研究对象的年龄、性别、T淋巴细胞亚群CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)以及血清免疫球蛋白IgG、IgM、IgA水平;采用实时定量荧光PCR(qRT-PCR)法检测血清中FOXP3 mRNA表达水平;采用酶联免疫吸附(ELISA)法检测血清中CXCL8表达水平;Pearson法分析CXCL8与FOXP3表达的相关性;利用受试者工作特征曲线(ROC)评价血清CXCL8、FOXP3水平对艾滋病的诊断价值。结果与对照组比较,艾滋组患者血清中CXCL8表达水平明显上调,FOXP3 mRNA表达水平下调,差异均具有统计学意义(P<0.05),CXCL8和FOXP3 mRNA的表达呈明显负相关(r=-0.350,P<0.05);艾滋病患者血清中CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)细胞计数显著低于健康人群,IgG、IgM、IgA水平显著高于健康人群,差异有统计学意义(P<0.05);艾滋病患者血清中CXCL8表达与CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)呈负相关(P<0.05),与IgG、IgM、IgA呈正相关(P<0.05),FOXP3 mRNA与CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)表达呈正相关(P<0.05),与IgG、IgM、IgA表达呈负相关(P<0.05);血清CXCL8、FOXP3水平联合预测艾滋病患者的ROC曲线下面积为0.981(95%CI:0.940~0.997),敏感度为98.61%,特异度为91.67%,显著高于CXCL8、FOXP3单独诊断。结论CXCL8在艾滋病患者血清中呈高表达,FOXP3呈低表达,二者呈明显负相关,与艾滋病疾病的发生发展密切相关,且对诊断艾滋病患者具有重要意义。

Objective:To investigate the expression and clinical significance of chemokine 8(CXCL8)and forkhead box P3(FOXP3)in the serum of AIDS patients.Methods:Seventy-two AIDS patients who came to our hospital from May 2018 to May 2021 were selected as the AIDS group,and 60 healthy people who came to our hospital for physical examination during the same period and matched with the general information of the patients were selected as the control group.The general data were collected,and the age,gender,T lymphocyte subgroup CD4^(+),CD8^(+),CD4^(+)/CD8^(+)levels and serum immunoglobulin IgG,IgM,IgA levels of the two groups were compared.Real-time quantitative fluorescent PCR(qRTPCR)method was used to detect the expression level of FOXP3 mRNA in serum,enzyme-linked immunosorbent(ELISA)method was used to detect the expression level of CXCL8 in serum,and Pearson method was used to analyze the correlation between CXCL8 and FOXP3 expression.Receiver operating characteristic curve(ROC)was used to evaluate the diagnostic value of serum CXCL8 and FOXP3 levels for AIDS.Results:Compared with the control group,the serum CXCL8 expression level in the AIDS group was significantly up-regulated,and the FOXP3 mRNA expression level was downregulated,the difference was statistically significant(P<0.05),and the CXCL8 and FOXP3 mRNA expression levels were significantly negatively correlated(r=-0.350,P<0.05);the levels of CD4^(+),CD8^(+),CD4^(+)/CD8^(+)in serum of AIDS patients were significantly lower than those of healthy people,and the levels of IgG,IgM and IgA were significantly higher than those of healthy people,which showed statistical significance(P<0.05);CXCL8 expression was negatively correlated with CD4^(+),CD8^(+),CD4^(+)/CD8^(+)(P<0.05),positively correlated with IgG,IgM,and IgA(P<0.05),FOXP3 mRNA was positively correlated with CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)expressions(P<0.05),and negatively correlated with the expressions of IgG,IgM and IgA(P<0.05).The combined prediction of serum CXCL8 and FOXP3 levels in AIDS patients was 0.981(95%CI:0.940~0.997),with sensitivity at 98.61%and specificity at 91.67%,which were significantly higher than CXCL8 and FOXP3 alone.Conclusion:CXCL8 is highly expressed in the serum of AIDS patients,and FOXP3 is low.The two are obviously negatively correlated,and are closely related to the occurrence and development of AIDS,which are of great significance for the diagnosis of AIDS patients.