卡介菌多糖核酸对尖锐湿疣病人外周血CD8~+T细胞细胞因子表达影响

目的:研究卡介菌多糖核酸(BCG-PSN)对尖锐湿疣(CA)病人外周血CD8q+T细胞内白细胞介素类(IL-2、IL-4、IL-12)和干扰素γ(IFN-γ)表达的影响。方法:60例CA病人分为2组,均采用CO_2激光去除疣体。BCG-PSN组40例,激光术后开始加用BCG-PSN 1.0mg,im,qod,连续18次,36d为一个疗程。病例对照组20例,激光术后未再用任何药物治疗。另设正常对照组20例。采用流式细胞仪测定3组外周血CD8+T细胞IL-2、IL-4、IL-12、IFN-γ的水平。结果:治疗前CA病人外周血IL-2、IL-12和IFN-γ阳性CD8+T细胞百分率显著低于正常对照组,Tcl/Tc2亦显著低于正常对照组(P<0.01)。治疗后BCG-PSN组外周血IL-2、IL-12和IFN-γ阳性CD8+T细胞百分率显著升高(P<0.01),病例对照组无显著变化(P>0.05),2组变化差异非常显著(P<0.01)。BCG-PSN组治愈率82％,显著高于病例对照组(45％,P<0.01);复发率18％,低于病例对照组(55％,P<0.01)。结论:CA病人存在Tcl/Tc2失调,BCG-PSN可通过上调CA病人外周血CD8+T细胞IL-2、IL-12、IFN-γ的表达,纠正机体细胞因子失调而提高CA病人临床疗效、减少其复发。

Regulation of polysaccharide nucleic acid fraction of Bacillus Calmette-Guerin on cytokines of CD8+T lymphocytes in peripheral blood of patients with condylomata acuminata

AIM:To investigate the effects of polysaccharide nucleic acid fraction of Bacillus Calemette- Guerin(BCG-PSN)on the cytokines(IL-2,IL-4,IL-12 and IFN-γ)of CD8+T lymphocytes in patients with condyloma acuminatum(CA).METHODS:Flow cytometric analysis was employed to study intracellular cytokines(IL-2,IL-4,IL-12 and IFN-γ)of CD8+T lymphocytes in peripheral blood of 60 patients with CA (40 patients treated with CO_2 laser plus BCG-PSN,1.0mg,im,qod,the course lasted for 36d;20 patients treated with CO_2 laser only)and those of 20 healthy controls.RESULTS:Before treatment,the percentage of IL-2-producing,IL-12-producing and IFN-γ-producing CD8+T lymphocytes were significantly lower(P<0.01), while the ratio of Tc1/Tc2 was lower in CA patients than those in healthy controls(P<0.01).The percentages of IL-2-producing,IL-12-producing and IFN-γ-producing CD8+T lymphocytes significantly increased(P<0.01), and the ratio of Tcl/Tc2 returned to normal in CA patients after treatment with BCG-PSN.The percentages of IL-2 -producing,IL-12-producing and IFN-γ-producing CD8+T lymphocytes showed no significant changes in case- control group before and after treatment(P>0.05).The clinical cure rate in BCG-PSN group was significantly higher than that of case-control group(82% vs 45%,P<0.01);the recurrent rate in BCG-PSN group was significantly lower than that of case-control group(18% vs 55%,P<0.01).CONCLUSION:There are Tc1/Tc2 imbalance in the peripheral blood of CA patients.Treatment with BCG-PSN can induce effectively the levels of IL-2,IL-12 and IFN-γin the CD8+T lymphocytes,regulating the Tc1/Tc2 imbalance and in terms can significantly increase the clinical cure rate,and decrease the recurrent rate in CA patients.