HIV/AIDS患者CCR5、CXCR4的表达与疾病进展的关系

目的　了解HIV AIDS患者淋巴细胞表面第二受体CCR5、CXCR4的表达 ,分析其与疾病进展的关系 ,探讨HIV感染的免疫基础。方法　收集 33例HIV AIDS患者及 13例健康对照的抗凝全血 ,用流式细胞仪检测第二受体CCR5、CXCR4的表达 ,并分析第二受体表达与病毒载量、CD4 + T淋巴细胞绝对值及T淋巴细胞活化 (HLA DR+ CD38+ )的相关性。结果　艾滋病组CD4 + 、CD8+ T淋巴细胞表面CCR5表达高于无症状HIV 1感染组及健康对照 (P <0 .0 0 1) ;艾滋病组CD8+ T淋巴细胞表面CXCR4表达低于健康对照 (P <0 .0 1)。HIV AIDS患者CD4 + 、CD8+ T淋巴细胞表面CCR5的表达与病毒载量明显正相关 (P <0 .0 1) ;与CD4 + T淋巴细胞绝对值明显负相关 (P <0 .0 1) ,与T淋巴细胞活化(HLA DR+ CD38+ )水平明显正相关 (P <0 .0 0 1)。结论　HIV 1感染者第二受体CCR5的表达与机体对HIV的免疫反应及疾病进展密切相关。     

高效抗逆转录病毒治疗对中国HIV/AIDS患者淋巴细胞活化及第二受体表达的影响

目的　了解高效抗逆转录病毒治疗后中国HIV/ AIDS患者淋巴细胞活化及CCR5、CXCR4表达的变化,探讨HIV感染者对于抗病毒治疗的免疫应答。方法　10例HIV /AIDS患者给予高效抗逆转录病毒治疗(HAART),用流式细胞仪检测治疗前和治疗第3、6 个月T淋巴细胞活化(HLA DR、CD38表达)及第二受体CCR5、CXCR4表达情况,比较HIV/ AIDS患者治疗前后淋巴细胞活化、第二受体表达的变化。结果　治疗前,10例HIV /AIDS患者CD4+、CD8+ T淋巴细胞活化水平均明显高于健康对照,CD8+ T淋巴细胞表面CCR5的表达明显高于健康对照,CXCR4 的表达明显低于健康对照(P<0.05);HAART治疗后,患者淋巴细胞活化水平随治疗时间明显下降(P<0.05),CD8+ T淋巴细胞表面CCR5表达水平显著降低(P< 0. 01), CXCR4 的表达升高;治疗6 个月时, CD38 CD4、HLA DRCD38 CD4、CCR5 CD8、CXCR4 CD8表达水平恢复至健康人水平;HIV AIDS淋巴细胞活化水平及第二受体CCR5的表达降低与HAART治疗后CD4+T淋巴细胞数量的升高具有显著的相关性。结论HAART能够降低中国HIV /AIDS患者淋巴细胞活化水平,使第二受体表达水平趋于正常,促进免疫功能的恢复。     

趋化因子及受体与中国HCV/HIV合并感染相关性的研究

目的：探讨趋化因子自细胞介素8（IL-8）、干扰素诱导蛋白10（IFN-inducible 10-kdaprotein，IP-10）及趋化因子受体CCR5、CXCR3，在丙肝病毒（HCV）单纯感染，艾滋病病毒（HIV）单纯感染和HCV／HIV合并感染过程中的表达及意义。方法：采用流式细胞术，检测HCV感染组（n=21）、HIV感染组（n=14）、HCV／HIV感染组（n=28）及正常对照组（n=30）人外周血CD4^＋T淋巴细胞和CD8^＋T淋巴细胞表面CCR5、CXCR3的表达。ELISA方法检测血清趋化因子IL-8、IP-10含量。结果：HCV感染组、HIV感染组和HCV／HIV合并感染组，血清IP-10水平都明显升高，而在合并感染组水平最高；血清IL-8水平在3组亦明显升高。HIV感染组及HCV／HIV合并感染组CD4^＋T细胞表面CXCR3表达显著降低（P〈0．001），CD8^＋T细胞表面CXCR3表达显著升高（P〈0．001）；HCV感染组CD4^＋及CD8^＋T细胞表面CXCR3表达轻度升高，但差异不显著。HCV感染组及HCV／HIV合并感染组CD4^＋及CD8^＋T细胞表面CCR5表达显著降低（P〈0.001）；HIV感染组CD4^＋及CD8^＋T细胞表面CCR5表达显著升高（P〈0.001）。结论：中国HCV／HIV合并感染患者中，血清IL-8和IP-10水平都明显升高；受体CXCR3在CD4^＋T细胞表面表达降低，而在CD8^＋T细胞表面表达升高；受体CCR5在CD4^＋及CD8^＋T细胞表面表达降低，提示趋化因子及受体与HCV／HIV合并感染密切相关。     

中国经采供血HIV感染长期不进展者CD4~+T淋巴细胞趋化因子受体表达研究

目的:了解中国经采供血HIV感染长期不进展者CD4+T淋巴细胞趋化因子受体表达,分析其与疾病不进展的关系。方法:收集43例经采供血HIV感染长期不进展者、82例无症状HIV感染者、35例AIDS病人及40例健康对照的抗凝全血,用流式细胞仪检测趋化因子受体CCR5、CXCR4的表达,并分析其与病毒载量、CD4+T淋巴细胞绝对值及T淋巴细胞活化的相关性。结果:长期不进展组CD4+T细胞表面CCR5的表达明显低于无症状HIV感染组及AIDS组(P0.01),与健康对照无显著差异;CD4+T细胞表面CXCR4的表达各组无显著差异。CD4+T细胞表面CCR5的表达与CD4+T细胞数量显著负相关(r=-0.498,P0.05),与病毒载量无显著相关性。CD4+T细胞表面CCR5的表达与HLA、CD38在CD4+、CD8+T细胞的表达水平显著正相关(P0.001,CD38在CD4+T细胞的表达除外),CD4+T细胞表面CXCR4的表达与HLA在CD4、CD8+T细胞的表达水平显著负相关(P0.01)。结论:HIV感染长期不进展者CD4+T细胞趋化因子受体CCR5表达维持较低水平,与疾病不进展相关。     

HIV/HCV合并感染者淋巴细胞活化及第二受体表达的研究

目的了解中国不同疾病进展阶段人类免疫缺陷病毒和丙型肝炎病毒（HIV／HCV）合并感染者T淋巴细胞与自然杀伤细胞（natural killer cells，NK）数量变化及T淋巴细胞活化、受体表达情况，并探讨HCV感染对HIV感染免疫指标及疾病进展的影响。方法应用流式细胞术分析228例不同疾病进展阶段的HIV／HCV合并感染者及101例单纯HIV感染者外周血T淋巴细胞、NK细胞数量及T淋巴细胞活化受体（HLA-DR、CD38）、第二受体（CCR5、CXCR4）表达情况。结果（1）HIV／HCV合并感染组中，CD4^＋T淋巴细胞、NK细胞数量随疾病进展持续下降，其中艾滋病组（AIDS）明显低于无症状HIV感染组（HIV）（P〈0．05），HIV组明显低于长期不进展组（LTNP）（P〈0．01），LTNP组与健康对照组差异无统计学意义。LTNP组、HIV组及AIDS组CD4^＋、CD8^＋T细胞表面活化受体HLA-DR、CD38的表达依次升高，其中各组间CD8／CD38的升高差异均有统计学意义（P〈0．05），AIDS组CD4／HLA-DR、CD8／HLA-DR的升高明显高于LTNP组和HIV组（P〈0．01）。LTNP组、HIV组及AIDS组CD4^＋、CD3^＋T细胞表面CCR5的表达亦依次升高，各组间差异均有统计学意义（P〈0．05）；CD3^＋T细胞表面CXCR4的表达依次升高，AIDS组明显高于HIV组和LTNP组（P〈0．01）。（2）HIV／HCV合并感染组与单纯HIV感染组相比，AIDS组NK细胞明显下降（P〈0．05），CD4^＋T细胞下降，但无统计学意义，CD4／HLA-DR、CD8／HLA-DR、CD4／CXCR4、CD3／CXCR4明显升高（P〈0．01）；HIV组NK细胞明显下降（P〈0．01），CD4／CXCR4明显升高（P〈0．05）；LTNP组各项指标与单纯HIV感染组相比差异无统计学意义。（3）HIV／HCV合并感染组的HIV病毒载量随疾病进展不断升高，与单纯HIV感染组相比差异无统计学意义；HCV病毒载量在疾病不同阶段差异无统计学意义（P〉0．05）。结论随疾病进展，HIV／HCV合并感染者的免疫功能逐渐下降，HIV病毒载量逐渐升高。与单纯HIV感染相比，合并HCV感染可通过破坏机体天然免疫功能、促进免疫系统活化和受体表达，加速HIV感染的疾病进展。     

趋化因子受体CCR5、CCR7、CXCR3和CXCR6在丙肝患者肝内及外周血CD4+ T淋巴细胞上的表达及其意义

目的比较趋化因子受体CCR5、CCR7、CXCR3和CXCR6在丙肝患者肝内和外周血CD4^＋T淋巴细胞表面表达水平及其意义,同时进一步了解其与肝脏组织学炎症反应的关系.方法采用荧光标记抗趋化因子受体的单克隆抗体对肝内及外周血中CD4^＋T淋巴细胞表面的趋化因子受体进行染色后,采用9色11参数流式细胞仪LSRⅡ进行检测分析.结果（1）肝内CCR5^＋、CXCR3^＋或/和CXCR6^＋的CD4^＋T淋巴细胞频数高于外周血（P＜0.001）,而CCR7^＋CD4^＋T淋巴细胞频数低于外周血（P＜0.001）;（2）肝内CCR5^＋或CXCR6^＋的活性（CD38^＋）CD4^＋T淋巴细胞频数高于外周血（P＜0.05）;（3）肝内表达2种或2种以上趋化因子受体CCR5、CXCR3和CXCR6的CD4^＋T淋巴细胞频数明显高于外周血（P＜0.001）,而不表达或仅表达一种上述趋化因子受体CD4^＋T淋巴细胞频数明显低于外周血（P＜0.001）;（3）CCR5和CXCR6在肝内CD4^＋T淋巴细胞表面的表达有中等度相关;（4）肝内组织学炎症明显组表达趋化因子受体CCR5、CXCR3或CXCR6的CD4^＋T淋巴细胞频数高于炎症轻微组.结论趋化因子受体CCR5、CXCR3和CXCR6可能介导CD4^＋T淋巴细胞向肝内迁徙定植,并参与肝脏炎症的病理免疫学反应过程.     

DNAM-1在系统性红斑狼疮患者T淋巴细胞的表达研究

目的：研究DNAM－1在SLE患者外周血T淋巴细胞亚群上的表达，以阐明DNAM－1抗原在SLE患者体内活化作用以及与SLE发病的关系。方法：31例SLE患者和30例健康志愿者外周血单个核细胞，在PHA刺激培养72小时后，三色荧光标记的单克隆抗体染色，利用流式细胞仪测定T淋巴细胞亚群膜表面DNAM－1抗原的表达。同时检测SLE患者抗dsDNA抗体、C3和C4补体，疾病活动性用SLEDAI记分。结果：SLE患者CD4^＋、CD8^＋淋巴细胞上DNAM－1表达率均高于正常对照组（P＜0．01）；活动期SLE组CD4^＋、CD8^＋细胞上DNAM－1表达高于正常对照组和静止期SLE组（P＜0．01），而静止期SLE组与正常对照组无明显性差异（P＞0．05）；SLE患者CD8^＋细胞DNAM－1表达与SLEDAI、抗dsDNA抗体之间呈显著正相关（P＜0．001），与C3和C4补体水平呈明显负相关（P＜0．05），CD4^＋细胞DNAM－1表达与SLEDAI、抗dsDNA抗体、C3和C4补体之间无明显相关性（P＞0．05）。结论：SLE患者内存在T细胞亚群异常活化；活动期SLE患者T淋巴细胞亚群DNA－1表达增高；SLE患者CD8^＋细胞DNAM－1表达异常与SLEDAI、抗dsDNA抗体、C3和C4补体之间有明显相关，CD8^＋细胞活化程度可能与SLE疾病严重程度有关，故DNAM－1可能参与了SLE的免疫发病机理。     

肠黏膜Th17细胞在HIV/AIDS病理过程中的作用

人类免疫缺陷病毒(Human immunodeficiency virus,HIV)主要利用CD4为受体、CCR5和CXCR4为辅助受体感染人CD4+T淋巴细胞,并在大多数感染者中引发获得性免疫缺陷综合征(acquired immunodeficiency syndrome,AIDS)[1].肠相关淋巴组织(gut-associated lymphoid tissue,GALT)具有丰富的CD4+ CCR5+T淋巴细胞,是HIV感染的主要靶组织.现已有研究表明,CD4+T细胞缺失和持续的免疫活化是HIV感染的主要免疫病理特征.病毒感染导致肠道免疫系统结构和功能的损伤、黏膜屏障破坏,从而导致机体慢性免疫活化,这可能是HIV-1致病的重要机制[2-3].     

滤泡树突状细胞对T细胞活化、凋亡相关分子及第二受体表达作用的研究

目的:研究滤泡树突状细胞(Follicular dendritic cells,FDC)对T细胞活化、凋亡及受体表达的作用.方法:应用密度梯度离心法分离培养扁桃体FDC和外周血淋巴细胞,将FDC或FDC培养上清与淋巴细胞共培养5天,收集培养细胞,应用流式细胞术分析共培养后T细胞活化受体(CD38)、凋亡受体(CD95)及第二受体(CCR5、CXCR4)表达情况,用ELISA方法测定培养上清中TNF-α含量.结果:FDC和FDC培养上清能够显著增强CD4 T细胞表面活化标志CD38、第二受体CX-CR4的表达(P＜0.05),并且能够显著抑制CD4 T淋巴细胞凋亡标志CD95的表达(P＜0.05).FDC和FDC培养上清能够促进T淋巴细胞分泌TNF-α(P＜0.05).结论:FDC可促进CD4 T淋巴细胞的活化和第二受体CXCR4的表达,抑制CD4 T细胞的凋亡,并且能够促进T细胞分泌TNF-α.     

婴儿肠道不同部位T细胞亚群及其表面分子检测——婴儿肠道HIV-感染和复制的可能性分析

通过对婴儿外周血(PB)、肠系膜淋巴结(MLN)和肠上皮内(IE)来源淋巴细胞的比较性研究,以分析婴儿肠道HIV-1感染容许性和HIV-1复制支持性的细胞与分子基础。分离婴儿外周血单个核细胞(PBMC),肠系膜淋巴结淋巴细胞(MLNL)和肠上皮间淋巴细胞(iIEL),制备单细胞悬液,运用流式细胞术结合荧光抗体染色技术:(1)检测不同部位的CD3+T细胞中CD4+辅助性T细胞和CD8+杀伤性T细胞比例;(2)检测不同部位的CD4+T细胞CCR5和CXCR4以及CD69和HLA-DR的表达水平。结果发现:(1)iIEL中的CD4+辅助性T细胞占CD3+T细胞的比例明显低于PBMC和MLNL,而CD8+杀伤性T细胞占CD3+T细胞的比例明显高于PBMC和MLNL;(2)iIEL中CD4+T细胞CCR5和CXCR4以及CD69和HLA-DR的表达水平均明显高于PBMC和MLNL。结果表明:婴儿iIEL中CD4+T淋巴细胞与PBMC和MLNL的CD4+T淋巴细胞相比较,高表达HIV-1入胞共受体CCR5和CXCR4,提示iIEL更易被HIV-1感染;iIEL中CD4+T淋巴细胞高表达细胞活化标记分子CD69和HLA-DR,说明其更有利于HIV-1复制,这种高基础活化率可能与其不断接触小肠来源的食物和共生菌抗原有关。由此可见,婴儿肠道具有了HIV-1感染容许性和HIV-1复制支持性的细胞和分子基础,因此成了HIV-1最易感的解剖部位,这可能是围产期HIV感染的婴儿病毒载量明显高于成年人,且病情进展也比成年人快的原因。     

Activation and Coreceptor Expression of T Lymphocytes in HIV/AIDS Patients of China

The objective of this paper was to investigate the activation and coreceptor CCR5, CXCR4 expression of T lymphocytes in HIV/AIDS patients of China, and to study their association with disease progression. Seventy-seven HIV/AIDS patients and thirteen normal controls were enrolled and three-color flow-cytometry was used to detect the activation marker HLA-DR, CD38 and the coreceptor CCR5, CXCR4 expression on T lymphocytes in whole blood samples taken from the patients and the controls. The HLA-DR, CD38 and CCR5 expression on CD4, CD8⁺ T cells in AIDS patients was higher than in asymptomatic HIV-1 infected patients and normal controls (p < 0.05); The activation and CCR5 expression on T lymphocytes significantly correlated with CD4⁺ T lymphocyte number and viral load. The activation on T lymphocytes and the expression of CCR5 on T lymphocytes in HIV/AIDS patients of China are significantly correlated with disease progression.     

T cell activation and disease severity in HIV infection.

In vitro studies have indicated that T lymphocyte activation may be of importance in the pathogenesis of HIV infection. In order to define the role of immune activation in vivo, we assessed the expression of the T cell activation markers HLA-DR and CD25 by flow cytometry in peripheral blood in relation to disease severity and the surrogate markers CD4 and beta 2-microglobulin in 157 patients with HIV infection and 53 healthy seronegative blood donors. Percentage levels of CD3+HLA-DR+ T lymphocytes were significantly higher (P < 0.0001) and percentage levels of CD3+CD25+ T lymphocytes significantly lower (P < 0.0001) in all HIV+ patients compared with controls. A significant correlation was observed between increasing percentage levels of CD3+HLA-DR+ T lymphocytes and both declining CD4 counts (r = 0.52; P < 0.001) and increasing beta 2-microglobulin levels (r = 0.56; P < 0.001). Percentage levels of CD4+HLA-DR+ and CD4+ CD25+ lymphocytes were significantly higher in all HIV+ patients compared with controls (P < 0.001). Levels of activated (HLA-DR+ and CD25+) CD4+ lymphocytes showed a significant step-wise linear increase with increasing disease severity (P < 0.001). High levels of CD3+HLA-DR+ T lymphocytes were found in a greater proportion (81.8%) of asymptomatic HIV+ patients (Centres for Disease Control (CDC) group II) than low CD4 counts (51.5%) (P < 0.001). Compared with controls, HIV+ patients had higher percentage levels of CD8+HLA-DR+ lymphocytes (P < 0.001), but similar levels of CD8+CD25+ lymphocytes. These results indicate that T cell activation is not only a consistent but also an early feature in HIV infection. Monitoring levels of activated T cells and their subsets is of value in assessing progression of HIV-related disease.     

Increased CCR5 and CXCR4 expression in Ethiopians living in Israel: environmental and constitutive factors.

HIV coreceptors play a major role in determining susceptibility and HIV cell tropism. The present work studied whether the high expression of these coreceptors found on lymphocytes and monocytes of Ethiopian immigrants to Israel (ETH) is the result of environmental and/or constitutive genetic factors. The study of 26 ETH shortly after their arrival to Israel (new ETH), 22 ETH in Israel over 7 years (old ETH), and 20 Caucasian Israelis (non-ETH) enabled us to address this issue. The new ETH had elevated levels of activated HLA-DR+CD4+ and CD38+CD8+ cells in comparison with both old ETH and non-ETH groups (P < 0.01), most probably related to chronic helminthic infections. Surface CCR5 expression, i.e., the percentage of CCR5+ cells and the number of CCR5 molecules/cell, was higher (2- to 3- and 8- to 31-fold, respectively) in activated than in nonactivated CD4+ cells, in all groups. However, CCR5 expression, in both activated and nonactivated CD4+ cells, was higher in both ETH groups than in the non-ETH group. CXCR4 expression was higher in nonactivated CD4+ cells in all groups and was also higher in both ETH groups, in both activated and nonactivated CD4+ cells, than in the non-ETH group. These findings suggest that constitutive factors, in addition to immune activation caused by environmental factors, account for the elevated expression of CCR5 and CXCR4 on CD4+ cells of ETH. This increased HIV coreceptor expression may make ETH more susceptible to HIV infection and may account in part for the rapid spread of AIDS in Ethiopia and the rest of Africa as well.     

Downregulation of CCR5 on activated CD4 T cells in HIV-infected Indians

BACKGROUND: HIV infection in India is unique as it occurs predominantly by CCR5-utilizing isolates that exhibit no co-receptor switch. OBJECTIVES: To study HIV-1 co-receptor dynamics on T cells and monocytes following viral infection. STUDY DESIGN: HIV co-receptor expression was evaluated by flow cytometry on various cell subsets in HIV-infected Indians and in vitro in human peripheral blood mononuclear cells infected with CCR5- or CXCR4-utilizing HIV-1. Transfection of the T cell line CEM-CCR5 (which expresses CD4, CCR5 and CXCR4) with HIV-1 Nef or Vpu expression vectors, or treatment with recombinant soluble gp120 from CCR5- and CXCR4-tropic HIV-1, was carried out to determine their effects on co-receptor expression. RESULTS: Indian HIV patients had fewer CD4(+)CCR5(+) T cells and CCR5-expressing activated CD4(+) T cells, but higher CXCR4-expressing activated CD4(+) T cells compared with controls. Expression of CCR5 was not different on monocytes in HIV patients as compared to controls. The CCR5 downregulation on T cells was HIV infection specific and was governed by the co-receptor-utilization phenotype of the virus. The Nef and soluble gp120 proteins induced CCR5 downregulation, the latter in a co-receptor-utilization phenotype specific manner. CONCLUSIONS: The HIV-1 co-receptor dynamics in Indian patients is distinct from western patients and depends upon the virus surface protein. We propose this to be a viral survival strategy.     

Expression of chemokine receptors CCR5 and CXCR4 on CD4+ T cells and plasma chemokine levels during treatment of active tuberculosis in HIV-1-coinfected patients

The pathogenesis of persistently elevated plasma HIV viremia in patients coinfected with tuberculosis (TB) during anti-TB treatment in Africans remains unknown. We examined the expression of chemokine receptors CCR5 and CXCR4 on CD4+ T cells and plasma chemokine levels of macrophage inflammatory protein (MIP)-1alpha, MIP-1beta, regulated on activation normal T expressed and secreted (RANTES), and stromal cell-derived factor (SDF)-1alpha among TB patients with HIV coinfection during the first 2 months of anti-TB treatment. During treatment of TB, the plasma HIV-1 load and CD4+ T-cell count remained unchanged. Levels of CCR5 and CXCR4 expression on CD4+ T cells as well as plasma levels of chemokines remained persistently elevated during anti-TB treatment. Persistently elevated plasma HIV viremia also paralleled persistently elevated expressions of activated CCR5+ or CXCR4+ CD4+ T cells. These results suggest that increased expression of CCR5 and CXCR4 on an activated CD4+ T-cell population coupled with persistently elevated chemokines may provide a suitable condition for continuous replication of HIV associated with TB coinfection. This, in turn, may contribute, at least in part, to the observed persistently elevated plasma HIV viremia in coinfected patients despite anti-TB treatment.