肾综合征出血热CD178 +T淋巴细胞本质的临床研究

目的探讨肾综合征出血热(hemorrhagicfeverwithrenalsyndrome,HFRS)患者CD178 T淋巴细胞的本质及其在致病过程中的作用。方法应用流式细胞仪(flowcytometry,FCM)对56份HFRS患者外周血标本进行检测,分析CD178在HFRS淋巴细胞亚群和活化淋巴细胞中的表达及其动态变化。结果HFRS发热期和多尿期CD4 CD178 及CD8 CD178 T淋巴细胞与对照组比较明显增加,差异具有统计学意义。HFRS发热期和多尿期CD178在CD4 HLADR T淋巴细胞群及CD8 HLADR T淋巴细胞群表达均明显增高,与正常对照组比较,差异具有统计学意义;而发热期与多尿期之间比较,差异无统计学意义。结论HFRS的发病过程中CD178表达于活化CD4 淋巴细胞亚群,主要表达于CD8 T细胞亚群,且病程早期和后期均有高表达。推测在发病早期细胞毒T细胞(cytotoxicTlymphocyte,CTL)通过CD178介导的细胞调亡清除病毒感染的靶细胞,在疾病末期则通过清除活化的抗原特异性T细胞,维持机体免疫自身的稳定。

A clinical study on CD178 positive T lymphocyte in hemorrhagic fever with renal syndrome

Objective To further probe into the role of CD_ 178 in the pathogenesis of hemorrhagic fever with renal syndrome (HFRS). Method The expression of CD_ 178 and HLA-DR on T cell subsets in peripheral blood of patients with HFRS and their dynamic changes were detected by Flow cytometry. Results CD_4 CD_ 178 and CD_8 CD_ 178 T lymphocytes both in fever and polyuria phases were significantly higher than those in normal controls, while there was no significant difference between the both phases of HFRS (P>0.05). CD_ 178 expression on CD_4 HLA-DR and CD_8 HLA-DR T lymphocytes were significantly higher than those in normal controls (P<0.05, P<0.01, P<0.001, P<0.001), while there was no significant difference between CD_4 HLA-DR and CD_8 HLA-DR T lymphocytes (P>0.05). Conclusion CD_ 178 was expressed on both CD_4 and CD_8 T cell subsets, but mainly on CD_8 T cell subsets both in early stage and in later stage in the pathogenesis of HFRS. Cytotoxic T lymphocyte(CTL) might kill target cells infected by hantavirus (HV) and eliminate HV via cell apoptosis mediated by CD_ 178 in early stage of HFRS. In later stage of HFRS, CD_ 178 might reduce antigen-specific T lymphocytes by activation induced cell death(AICD) and help to maintain the homeostasis of immune system.