健艾康浓缩丸联合cART使用对HIV感染者肠道及其菌群的影响

Effect of Jianaikang concentrated pill combined with cART on the intestinal and intestinal flora of patients with HIV

目的研究健艾康浓缩丸联合cART对HIV感染者肠道的影响。方法纳入HIV感染者26例,试验组13例给予健艾康浓缩丸+cART,对照组13例给予健艾康浓缩丸安慰剂+cART,连续治疗48周。收集两组血液和粪便,通过细胞学检查、16SrRNA高通量测序、短链脂肪酸及肠黏膜损伤标志物测定并进行分析。结果试验组治疗后CD4^(+)CD45RO^(+)(269.77±57.78)表达水平较前(178.46±83.26)升高(P<0.01),CD4^(+)CCR5+(19.08±5.95)较前(10.46±9.98)升高(P<0.05),CD4^(+)CXCR4^(+)(174.77±63.23)较前(244.46±89.38)降低(P<0.05);对照组治疗后CD4/CD8细胞比值(0.81±0.37)较前(0.52±0.25)升高(P<0.05),CD4^(+)CD45RO^(+)(313.15±95.04)较前(195.38±77.56)升高(P<0.01)。在属水平,试验组绿脓杆菌属(Pseudomonas)、魏斯菌属(Weissella)、小链杆菌属(Catenibacterium)、放线菌属(Actinomyces)比例高于对照组(P<0.05),试验组泰泽雷拉菌属(Tyzzerella 4)比例低于对照组(P<0.05)。试验组除乙酸外其余短链脂肪酸水平低于对照组(P>0.05),试验组外周血肠黏膜损伤标志物含量均低于对照组(P>0.05)。结论经48周治疗后两组HIV感染者肠道存在一定差异。相较于仅用cART,联合健艾康浓缩丸对免疫重建起到协同作用,联合治疗能潜在上调益生菌比例,具有降低肠黏膜损伤风险的趋势。

Objective To study the effect of Jianaikang concentrated pill combined with antiretroviral therapy(cART) on the intestinal tract of patients with HIV.Methods A total of 26 patients with HIV were enrolled.13 patients in the test group were administered Jianaikang concentrated pill+cART,and 13 patients in the control group received Jianaikang concentrated pill placebo+cART,and all the patients were treated for 48 weeks.The blood and stool of the two groups were collected and analyzed by cytological examination,16SrRNA high-throughput sequencing,and shortchain fatty acids and intestinal mucosal injury markers.Results In the test group,the post-treatment expression level of CD4^(+)CD45RO^(+)(269.77±57.78) was higher than at pre-treatment (178.46±83.26)(P<0.01).Additionally,the post-treatment expression level of CD4^(+)CCR5^(+)(19.08±5.95) was higher than at pre-treatment (10.46±9.98)(P<0.05).Conversely,the post-treatment CD4^(+)CXCR4^(+)(174.77±63.23) was lower than that at pre-treatment (244.46±89.38)(P<0.05).In the control group,the post-treatment CD4/CD8 ratio (0.81±0.37) was higher than at pre-treatment (0.52±0.25)(P<0.05),and the posttreatment CD4^(+)CD45RO^(+)(313.15±95.04) was higher than at pre-treatment (195.38±77.56)(P<0.01).At the genus level,the proportions of Pseudomonas,Weissella,Catenibacterium,and Actinomyces in the test group were higher than those in the control group (P<0.05),whereas the proportion of Tyzzerella 4 in the test group was lower than that in the control group (P<0.05).The levels of all short-chain fatty acids,except for acetic acid,in the test group were lower than those in the control group (P>0.05),and the levels of all peripheral intestinal mucosal injury markers in the test group were lower than those in the control group (P>0.05).Conclusions After 48 weeks of treatment,the intestinal tract of the two groups of patients with HIV exhibited distinct differences.Compared with cART alone,combined treatment with Jianaikang concentrated pill produced a synergistic effect on immune reconstruction.Combination therapy can potentially increase the proportion of probiotics and showed a trend toward reducing the risk of intestinal mucosal injury.