尖锐湿疣皮损中人乳头瘤病毒感染状况及与外周血Treg/Th17平衡的相关性

Human papillomavirus infection in skin lesions of condyloma acuminatum and its correlation with peripheral blood Treg/Th17 cell balance

目的探讨尖锐湿疣皮损中人乳头瘤病毒感染状况及与外周血Treg/Th17细胞平衡的相关性。方法纳入2018年1月-2021年12月至本院皮肤科、肛肠科就诊的尖锐湿疣患者317例,为感染组。其中,尖锐湿疣初发患者211例,为初发组;尖锐湿疣复发患者106例,为复发组。纳入同期至本院体检的健康志愿者119例,为对照组。仅感染低危型HPV的患者有146例,为低危组;仅感染高危型HPV的患者有72例,为高危组;低危型和高危型HPV均感染的患者有99例,为混合组。实时荧光定量PCR仪进行人乳头瘤病毒基因分型的检测。流式细胞术计数外周血中Treg和Th17数目。结果低危型中HPV-6和HPV-11的感染率较高,分别为74.13%和23.66%;高危型中HPV-16和HPV-18的感染率较高,分别为14.83%和17.67%。在HPV感染模式中,单一感染模式的尖锐湿疣患者最多,占所有HPV阳性患者的55.52%(176/317),并且这一模式中低危型HPV患者多于高危型HPV患者。其次,在多重感染模式中,以二重感染为主,占所有HPV阳性患者的22.76%(88/317)。Th17细胞水平、Treg细胞水平、Treg/Th17细胞平衡水平在低危组、高危组、混合组中差异显著,其中Treg细胞水平和Treg/Th17细胞平衡水平在低危组中最低、在高危组中最高;Th17细胞水平在低危组中最高、在高危组中最低。感染组中Th17细胞水平低于对照组,但是Treg细胞水平和Treg/Th17细胞平衡水平高于对照组。复发组中Th17细胞水平低于初发组,但是Treg细胞水平和Treg/Th17细胞平衡水平高于初发组。此外,感染模式与Treg/Th17细胞平衡具有相关性;复发情况与Treg/Th17细胞平衡具有相关性。结论尖锐湿疣患者感染亚型主要为HPV-6、HPV-11、HPV-16和HPV-18,感染模式以单一亚型感染和低危型感染为主。尖锐湿疣的复发情况以及HPV感染情况与Treg/Th17细胞平衡均具有相关性。

Objective To investigate the relationship between human papillomavirus infection and peripheral blood Treg/Th17 cell balance in skin lesions of condyloma acuminatum.Methods 317 patients with condyloma acuminatum treated in dermatology and anorectal Department of our hospital from January 2018 to December 2021 were included as the infection group.Among them,211 cases of condyloma acuminatum patients,for the initial group;106 cases of recurrent condyloma were recurrence group.119 healthy volunteers who came to our hospital for physical examination during the same period were included as the control group.146 patients infected only with low-risk HPV were in the low-risk group.There were 72 patients infected only with high-risk HPV,which was in the high-risk group.Ninety-nine patients with both low-risk and high-risk HPV infection were in the mixed group.Genotyping of human papillomavirus was detected by real-time quantitative PCR.The number of Treg and Th1 in peripheral blood was counted by flow cytometry.Results The infection rates of HPV-6 and HPV-11 were 74.13%and 23.66%,respectively.Hpv-16 and HPV-18 had higher infection rates of 14.83%and 17.67%,respectively.In the HPV infection pattern,single infection pattern of patients with condyloma acuminatum,accounting for 55.52%of all HPV-positive patients(176/317),and this pattern of low-risk HPV patients more than high-risk HPV patients.Second,in the pattern of multiple infections,double infections dominated,accounting for 22.76%(88/317)of all HPV-positive patients.Th17 cell level,Treg cell level and Treg/Th17 cell balance level were significantly different in the low-risk group,high-risk group and mixed group.Treg cell level and Treg/Th17 cell balance level were the lowest in the low-risk group and the highest in the high-risk group.Th17 cell level was the highest in the low-risk group and the lowest in the high-risk group.The level of Th17 cells in the infected group was lower than that in the control group,but the level of Treg cells and the balance of Treg/Th17 cells were higher than that in the control group.The level of Th17 cells in the recurrence group was lower than that in the primary group,but the level of Treg cells and the balance of Treg/Th17 cells were higher than that in the primary group.In addition,infection pattern was correlated with Treg/Th17 cell balance(x~2=81.50,P<0.0001);recurrence was correlated with Treg/Th17 cell balance(x~2=855.071.50,P<0.0001).Conclusion The infection subtypes of patients with condyloma acuminatum are MAINLY HPV-6,HPV-11,HPV-16 and HPV-18,and the infection mode is mainly single subtype infection and low risk infection.The recurrence of condyloma acuminatum and HPV infection were correlated with the balance of Treg/Th17 cells.