iNKT细胞水平与HIV感染病程及HAART疗效的关系

Association of iNKT cell levels with the duration of HIV infection and the efficacy of HAART

目的探究恒定性自然杀伤T细胞(iNKT)水平与人类免疫缺陷病毒(HIV)感染患者病程及高效抗逆转录病毒治疗(HAART)疗效的关系.方法选取南通市第三人民医院2016年6月-2019年12月收治的艾滋病(AIDS)患者153例为研究组,包括无症状期78例(无症状期组)和艾滋病期75例(艾滋病期组),并招募健康人群50名作为对照组,采用流式细胞仪检测外周血CD_(4)^(+)、CD_(8)^(+)T淋巴细胞、iNKT细胞及其亚群水平,实时荧光定量聚合酶链反应(PCR)检测HIV RNA水平.结果研究组患者外周血CD_(4)^(+)T淋巴细胞、CD_(4)^(+)/CD_(8)^(+)、iNKT细胞及CD_(4)^(-)iNKT细胞水平低于对照组,CD_(8)^(+)T淋巴细胞、CD_(4)^(+)iNKT细胞和CD_(4)^(+)iNKT/CD_(4)^(-)iNKT水平高于对照组(P<0.05);艾滋病期组患者外周血CD_(4)^(+)T淋巴细胞、CD_(4)^(+)/CD_(8)^(+)、iNKT细胞及CD_(4)^(-)iNKT细胞水平低于无症状期组,CD_(8)^(+)T淋巴细胞、CD_(4)^(+)iNKT细胞和CD_(4)^(+)iNKT/CD_(4)^(-)iNKT水平高于无症状期组(P<0.05);无效组患者外周血CD_(4)^(+)/CD_(8)^(+)和iNKT细胞水平低于有效组,CD_(4)^(+)iNKT/CD_(4)^(-)iNKT水平高于有效组(P<0.05);受试者工作特征(ROC)曲线分析显示,iNKT细胞和CD _(4)^(+)iNKT/CD _(4)^(-)iNKT水平对患者HAART疗效具有一定的预测价值,曲线下面积(AUC)分别为0.779、0.756.结论AIDS患者外周血iNKT较健康人群降低,且随着病程进展CD_(4)^(+)iNKT/CD_(4)^(-)iNKT水平升高,iNKT细胞和CD_(4)^(+)iNKT/CD_(4)^(-)iNKT水平对患者HAART疗效具有一定的预测价值.

OBJECTIVE To investigate the relationship between invariant natural killer T cells(iNKT),the course of disease,and the efficacy of highly active antiretroviral therapy(HAART)in patients with human immunodeficiency virus(HIV)infection.METHODS A total of 153 patients with acquired immunodeficiency syndrome(AIDS)admitted to Nantong Third People's Hospital between Jun.2016 and Dec.2019 were selected as study group,including 78 cases in asymptomatic stage(asymptomatic stage group)and 75 cases in AIDS stage(AIDS stage group),and 5o healthy people were recruited as the control group.The levels of peripheral blood CD_(4)^(+) and CD_(8)^(+)T lymphocytes,iNKT and their subpopulations were detected by flow cytometry,and HIV RNA level was detected by real-time fluorescence quantitative polymerase chain reaction(PCR).RESULTS The levels of peripheral blood CD,+T lymphocytes,CD_(4)^(+)/CD_(8)^(+),iNKT and CD4-iNKT in study group were lower than those in control group,while levels of CD_(8)^(+) T lymphocytes,CD_(4)^(+)iNKT and CD_(4)^(+)iNKT/CD_(4)^(-)iNKT were higher than those in control group(P<0.05).The levels of peripheral blood CD_(4)^(+)T lymphocytes,CD_(4)^(+)/CD_(8)^(+),iNKT and CD,iNKT in AIDS stage group were lower than those in asymptomatic stage group,while levels of CD_(8)^(+)T lymphocytes,CD_(4)^(+)iNKT and CD_(4)^(+)iNKT/CD_(4)^(-)iNKT were higher than those in asymptomatic stage group(P<0.05).The levels of peripheral blood CD_(4)^(+)/CD_(8)^(+) and iNKT in ineffective group were lower than those in effective group,while CD_(4)^(+)iNKT/CD_(4)^(-)iNKT was higher than that in effective group(P<0.05).The analysis of receiver operating characteristic(ROC)curves showed that iNKT and CD_(4)^(+)iNKT/CD_(4)^(-)iNKT were of certain predictive value for HAART efficacy,with an area under the curve(AUC)of 0.779 and 0.756,respectively.CONCLUSION The expression level of peripheral blood iNKT was reduced in AIDS patients compared to healthy populations,and CD_(4)^(+)iNKT/CD_(4)^(-)iNKT levels were increased as the disease progresses.Levels of iNKT and CD_(4)^(+)iNKT/CD_(4)^(-) iNKT had certain predictive value for HAART efficacy.