HIV/AIDS患者抗病毒治疗后γ链细胞因子的变化及其意义

目的观察γ链细胞因子在艾滋病病毒（HIV）感染者/艾滋病（AIDS）病人（HIV/AIDS病人）和正常人表达水平的区别,及其在24个月的高效抗反转录病毒治疗（HAART）治疗中的动态变化,分析其与抗病毒治疗的关系及其临床意义。方法 40名HIV/AIDS病人在初次HAART治疗的0、6、12、18和24个月进行回访,另35名正常人作为对照,均采集外周血,用酶联免疫吸附试验（ELISA）检测常见的γ链细胞因子[白细胞介素2、4、7、15、21（IL-2、IL-4、IL-7、IL-15、IL-21）和γ干扰素（IFN-γ）],同时使用流式细胞计数法测定CD4＋T和CD8＋T淋巴细胞数量,实时反转录聚合酶链反应（RT-PCR）法测定血清中HIV核糖核酸（RNA）水平。结果未经抗病毒治疗的HIV/AIDS病人外周血IL-2、IL-15、IL-21和IFN-γ水平显著低于正常人,而IL-4和IL-7水平显著高于正常人。在启动HAART后的各次回访中,随着外周血HIV RNA病毒载量水平和CD8＋T淋巴细胞数量的逐渐下降和CD4＋T淋巴细胞数量的显著增加,IL-2、IL-15、IL-21和IFN-γ水平也逐步上升,而IL-4和IL-7水平逐步下降,显示出一定的相关关系。结论这些常见的γ链细胞因子可能和HIV感染的致病机制相关,并可能参与了抗病毒免疫重建和病毒控制过程

Changes and significance of the common y-chain cytokines after highly active antiretroviral therapy among HIV/AIDSpatients

To observe the different amounts of the common γ-chain cytokines among human immunodeficiency virus/aquired immunodeficiency syndrome （HIV/AIDS） patients and normal people and the dynamic changes during 24-month highly active antiretroviral therapy （HAART）. Method Forty untreated HIV-l-infected adults initiated HAART and were followed up at 0,6,12,18 and 24 months after the treatment. Thirty five normal individuals were enrolled as control. Their blood specimens were collected. Enzyme linked immunosorbent assay （ELISA） was used to detect the plasma level of IL 2, IL-4, IL-7, IL-15, IL-21 and IFN-γ. The amount of T cell subgroup was detected with flow cytometry. Real-time fluorescent quantitative polymerase chain reaction （PCR） was used to detect the serum HIV ribonucleic acid （RNA）. Result IL-2, IL-15,IL-21 and IFN-γ showed a significant increase while IL-4 and IL-7 showed a significant decrease after the initiation of HAART. With the increase of peripheral blood HIV RNA load and CD4^＋ T cells counts, IL-2, IL-15, IL-21 and IFN-7 were elevated gradually, while IL-4 and IL-7 declined, suggesting some correlation between the amount of cytokines and CD4^＋ T cells counts. Conclusion The common γ-chain cytokines which are related with the pathogenesis of HIV infection may play an important role in HIV virus immune reconstruction and virus control.