尖锐湿疣患者人乳头瘤病毒基因型分布及Th1/Th2亚群失衡与复发的关系

The relationship between human papilloma virus genotype distribution and helper T cell 1/helper T cell 2 subgroup imbalance of recurrence in patients with condyloma acuminatum

目的探讨感染不同基因型人乳头瘤病毒(HPV)及T淋巴细胞亚群状态与尖锐湿疣(CA)复发的关系。方法选取2019年1月至2020年12月新疆维吾尔自治区人民医院诊治的142例CA患者作为研究对象(CA组),采集疣体组织及外周血,根据是否复发分为CA复发组与CA非复发组。另选取同期20例健康人作为对照组,采集外周血。采用聚合酶链反应-反向杂交法检测疣体组织中HPV型别;采用流式细胞术检测外周血中T淋巴细胞亚群;采用流式微球分析法检测细胞因子的表达。结果CA组检出HPV感染亚型主要为HPV 11(47.18%)、HPV 6(38.73%)及HPV 16(19.01%),CA复发率为76.76%;CA患者CD4^(+)/CD8^(+)比值显著低于对照组(P<0.05),CA复发组Treg比率显著低于CA非复发组(P<0.05);CA复发组辅助性T(Th)1型细胞因子白介素-2(IL-2)及γ干扰素(IFN-γ)均显著低于CA非复发组(P<0.05),而Th2型细胞因子白介素-4(IL-4)及白介素-10(IL-10)均显著高于CA非复发组(P<0.05)。结论新疆地区CA患者HPV感染型别以HPV 11、6、16为主,同时均出现了T淋巴细胞亚群的紊乱及Th1/Th2细胞亚群的失衡,这种变化可能与CA发病期的免疫应答及CA复发期的免疫耐受存在关联。

Objective To clarify the relationship between infection with different genotypes of human papilloma virus(HPV)and the status of T lymphocyte subsets in patients with the recurrence of condyloma acuminatum(CA).Methods The patients with CA who were diagnosed and treated in the People′s Hospital of Xinjiang Uygur Autonomous Region from January 2019 to December 2020 were selected as the study objects(CA group),and the wart tissue and peripheral blood were collected.According to whether there was recurrence,patients were divided into CA recurrence group and CA non-recurrence group.A total of 20 healthy people in the same period were selected as control group and peripheral blood were collected.Polymerase chain reaction-reverse hybridization technology were used to detect HPV types in the wart tissue;flow cytometry was used to detect the subtype of T lymphocytes in peripheral blood.The expression of cytokines was detected by cytometricbeadarray.Results The main HPV infection types in CA group were HPV11(47.18%),HPV6(38.73%)and HPV16(19.01%),the recurrence rate of CA was 76.76%.The CD4~^(+)/CD8~^(+)ratio in CA patients was significantly lower than that in control group(P0.05);the Treg ratio of CA recurrence group was significantly lower than those in the CA non recurrence group(P0.05).The levels of helper T(Th)1 cytokines interleukin(IL)-2 and interferon-γ(IFN-γ)in CA recurrence group were significantly lower than those in CA non-recurrence group(P0.05);the levels of Th2 cytokines IL-4 and IL-10 in CA recurrence group were significantly higher than those in CA non-recurrence group(P0.05).Conclusions The HPV infection types of CA patients in Xinjiang district were mainly HPV 11,HPV 6 and HPV 16,and all of them showed disorder of T lymphocyte subsets and imbalance of Th1/Th2 cell subsets.Such changes may be related to immune response during the onset of CA and immune tolerance during the recurrence period of CA.