辅助性T细胞17在人类免疫缺陷病毒合并结核感染致病中的作用

目的 观察HIV合并结核感染患者IL-17的表达情况,探讨Thl7细胞在HIV合并结核感染致病中的作用.方法 将54例确诊的HIV感染患者,分为单纯HIV感染组、HIV合并潜伏结核感染组和HIV合并结核感染组,采用全血胞内细胞因子染色方法,使用BD FACSCanto流式细胞仪检测各项指标,FACSDiva软件分析CD4+ IL-17+T淋巴细胞及CD4+ IFNΥ+T淋巴细胞表达情况,组间比较采用独立样本配对t检验.结果 3组患者CD4+T淋巴细胞计数及病毒载量无明显区别；CD4+ IL-17+T淋巴细胞表达百分比单纯HIV感染组为(1.40±1.01)％,HIV合并结核潜伏感染组为(1.29±0.86)％,两组比较差异无统计学意义(t=0.336,P＞0.05),但均显著高于合并结核感染组的(0.58±0.43)％(t=3.680,t=2.516,P＜0.05)；3组患者之间CD4+IFNγ+T淋巴细胞表达百分比分别为(32.8±24.0)％、(40.3±21.9)％和(46.1±31.2)％,3组比较,差异无统计学意义(t=-0.939,t=-1.602,t=-0.646,均P＞0.05).结论 HIV合并结核感染患者出现明显的Th17应答下调,Th17细胞可能在HIV合并结核感染中起着重要的抗结核免疫保护作用.

The role of T helper type 17 cells in the pathogenesis of HIV/tuberculosis-coinfected patients

Objective To evaluate the IL-17 expression in HIV/tuberculosis-coinfected patients and its role in the pathogenesis of this coinfection.Methods Fifty-four HIV infected patients were divided into three groups:simple HIV infected group,HIV with latent tuberculosis infection (HIV+ LTBI) group and HIV coinfected with active tuberculosis (HIV+ ATB) group.The whole blood intracellular cytokine staining was performed and samples were then detected by BD FACSCanto.The expressions of CD4+ IL-17+ T cells and CD4+ IFNγ+ T cells were analyzed using FACSDiva software.Comparison between groups was done by independent sample t test.Results The CD4+ T cell count and viral load among these three groups were comparable.There were no significant difference of the expression of CD4+ IL-17+ T cells between simple HIV infected group and HIV+ LTBI group (1.40 ± 1.01) ％ vs (1.29±0.86) ％,(t=0.336,P＞0.05),but both of these two groups were much higher than HIV+ATB group (t=3.680,t=2.516,P＜0.05).There were no significant differences of the expression of CD4+ IFNγ+ T cells among these three groups (32.8±24.0)％ vs (40.3±1 21.9) ％ vs (46.1±31.2)％,(t=-0.939,t=-1.602,t=-0.646,P＞0.05)].Conclusion The Th17 response is down-regulated in HIV/tuberculosis-coinfected patients,which may play an important antitubercular role in the pathogenesis of coinfection.