艾滋病相关的卡波西肉瘤免疫激活状态研究

Immune activation in AIDS related Kaposi's sarcoma

目的 :进一步探讨免疫功能改变在艾滋病相关的卡波西肉瘤 (AIDS- KS)发病中的作用。方法 :对 12例AIDS- KS,32例无卡波西肉瘤的 HIV感染者 (HIV- NKS)和 16例正常对照进行了研究 ,用 EL ISA对 8例 AIDS- KS,2 8例 HIV- NKS和 16例正常对照血清 (或血浆 )进行了 s Fas,β 2 -微球蛋白 (β 2 - MG) ,IL - 10 ,IL- 16 ,IL- 18,IL- 6和可溶性 IL - 4受体 (s IL- 4R)测定 ,对 12例 AIDS- KS,32例 HIV- NKS外周血淋巴细胞、淋巴细胞亚群及 CD38+CD8,HLA- DR+ CD8进行了分析。结果 :β 2 - MG,s IL- 4R水平在 HIV- NKS组明显高于正常对照组 ,IL- 16水平在HIV- NKS组明显低于正常对照组 ,IL - 18水平在 HIV- NKS组和 AIDS- KS组均明显高于正常对照组 ;CD3、CD4、CD8、NK、HLA- DR+ CD8在 AIDS- KS均低于 HIV- NKS,而 AIDS- KS组 CD19、CD38+ CD8高于 HIV- NKS组 ,但各组间差异无显著性。结论 :AIDS- KS和 HIV- NKS一样存在一定程度的免疫激活 ,但 AIDS- KS和 HIV- NKS间免疫状态无明显差异 ,提示免疫状态的差异可能不是艾滋病患者并发卡波西肉瘤的主要原因。

Objective: To study the pathogenesis role of immune system activation in AIDS related Kaposi's sarcoma(AIDS KS). Method:The serum levels of sFas, β 2 microglobin,IL 10,IL 16,IL 18,IL 6 and sIL 4R were detected by ELISA in 8 AIDS KS patients,28 patients with HIV infection but without Kaposi's sarcoma(HIV NKS ) and 16 normal controls. The lymphocyte and their subsets, CD38 + CD8,HLA DR +CD8 in the peripheral blood mononuclear cell (PBMCs) in 12 AIDS KS and 32 HIV NKS were detected by flow cytometer. Results:β 2 MG and sIL 4R in HIV NKS were significantly higher than those in normal controls( P <0.05),IL 16 in HIV NKS was significantly lower than that in controls( P <0.05).IL 18 was higher in both AIDS KS and HIV NKS compared with normal controls. In AIDS KS, CD3, CD4, CD8, NK and HLA DR +CD8 were lower than those in HIV NKS whereas CD19 and CD38 +CD8 were higher than those in HIV NKS. But the difference was not statistically( P >0.05). Conclusion:Although both AIDS KS and HIV NKS demonstrate some activation of immune system, there appears to be no significant difference between immune responses in KS and NKS patients. These data suggest that the activation of the immune system is unlikely to contribute significantly to the pathogenesis of AIDS KS.[