传染性单核细胞增多症患儿EB病毒转化的"永生细胞"抑制途径的研究

目的探讨EB病毒(EBV)感染的传染性单核细胞增多症(IM)患儿EBV转化的"永生细胞"(CD23+细胞)抑制途径.方法用流式细胞术测定34例EBV感染的IM患儿急性期、恢复早期、恢复期外周血单个核细胞膜CD23、CD19、CD95、Bcl-2及CD23CD95和CD19CD23共表达情况,并与24名同龄健康儿童对照组比较.结果①急性期、恢复早期CD23+、CD23+CD19+细胞率明显下降,CD95+、CD95+CD23+、Bcl-2+细胞率明显升高[急性期CD95+、CD95+CD23+、Bcl-2+细胞率分别为(19.43±8.46)%,(1.81±1.71)%,(23.41±26.47)%;恢复早期分别为(12.94±5.05)%,(1.05±1.20)%,(10.54±9.68)%;而对照组分别为(10.39±2.90)%,(0.50±0.46)%,(7.25±2.88)%].病程越早,变化越明显,恢复期各参数均恢复到正常水平.②CD95+CD23+细胞与CD23+、CD23+CD19+细胞在急性期、恢复早期均呈正相关;Bcl-2+、CD3+细胞在急性期与CD23+、CD23+CD19+细胞呈正相关;急性期CD95+CD23+细胞与Bcl-2+细胞呈正相关;恢复期CD95+CD23+细胞与CD95+细胞呈正相关.结论在EBV感染儿童IM发病过程中,CD95L-CD95介导的凋亡途径对于EBV转化的"永生细胞"在体内的有效抑制起着主要的作用,而Bcl-2对CD95L-CD95介导的凋亡起拮抗作用.

The inhibition pathway of the EBV-immortalized cells in children with infectious mononucleosis

OBJECTIVE: To explore the inhibition pathway of the EBV-immortalized cells (CD23(+)) in children with infectious mononucleosis (IM) caused by Epstein-Barr virus. METHODS: The expressions of CD23, CD19, CD95, Bcl-2 and the co-expressions of CD23CD95, CD19CD23 on peripheral blood mononuclear cell (PBMC) were analyzed by flow cytometry (FCM) during acute phase, early convalescent phase and convalescent phase of 34 EBV-IM children and compared with that of 24 healthy donors. RESULTS: (1) The levels of CD23(+) and CD23(+)CD19(+) cells decreased and CD95(+), CD95(+)CD23(+), Bcl-2(+) cells increased markedly in IM patients in acute phase [CD95(+) cells (19.43 +/- 8.46)%; CD95(+)CD23(+) cells (1.81 +/- 1.71)%; Bcl-2(+) cells (23.41 +/- 26.47)%] and early convalescent phase [CD95(+) cells (12.94 +/- 5.05)%; CD95(+)CD23(+) (1.05 +/- 1.20)%; Bcl-2(+) cells (10.54 +/- 9.68)%], as compared with those of healthy controls [CD95(+) cells (10.39 +/- 2.90)%; CD95(+)CD23(+) cells (0.50 +/- 0.46)%; Bcl-2(+) cells (7.25 +/- 2.88)%]. The earlier the course of IM, the more abnormal the expressive levels. All the abnormal results returned to normal in convalescent phase. (2) Positive relationships were observed between the expressions of CD95(+)CD23(+) cells and that of CD23(+) cells, CD23(+)CD19(+) cells during acute and early convalescent phase, the expressions of Bcl-2(+), CD3(+) cells and CD23(+), CD23(+)CD19(+) cells during acute phase, the expressions of CD95(+)CD23(+) cells and Bcl-2(+) cells during acute phase, and the expressions of CD95(+)CD23(+) cells and CD95(+) cells during convalescent phase. CONCLUSION: The results indicate that CD95L-CD95 mediated apoptosis plays an important role in eliminating EBV-immortalized cells, which is counteracted partly by Bcl-2.