单纯疱疹-Ⅱ型病毒感染的皮损部位病毒载量与外周血Th及Tc的相关性研究

目的通过检测现症生殖器疱疹（genital herpes,GH）病人皮损部位的单纯疱疹2型病毒（HSV-2）载量,并检测其细胞免疫功能,分析GH患者HSV-2病毒载量与细胞免疫功能的相关性。方法采用荧光定量聚合酶链反应（fluorescent quantitative polymerase chain reaction,FQ-PCR）定量检测28例现症GH患者皮损部位HSV-2DNA载量,采用流式细胞计数的方法监测28例现症病人外周血具有分泌活性的Th及Tc所占比例,运用直线相关回归方法分析现症GH患者病毒载量与细胞免疫功能的相关性。结果①GH患者皮损内疱液HSV-2检出率为100%,病毒载量为（6190714±1962085）拷贝/mL。HSV-2病毒载量与患者复发次数呈显著正相关（P〈0.05）。②GH组Th1、Tc1细胞数和Th1/Th2、Tc1/Tc2比值均明显低于对照组（P〈0.01）,而Th2细胞数显著高于对照组（P〈0.01）。GH患者皮损HSV-2病毒载量与患者外周血Th1、Tc1细胞数和Th1/Th2、Tc1/Tc2比值呈显著的负相关,与Th2细胞数呈显著正相关。结论GH患者存在明显的细胞免疫功能抑制及Th、Tc细胞亚群分化失衡;GH患者的细胞免疫功能抑制可能是由于外周血T淋巴细胞亚群的变化和NK细胞减少,以及Th、Tc细胞亚群分化失衡造成,这种状态不利于机体抑制病毒复制和增殖,造成GH反复发作。

Study on the Relationships between Herpes Simplex Virus Type II Infection and the Proportions of Th and Tc Lymphocytes in Peripheral Blood

Objective To evaluate the association between virus loading in the lesion of Herpes Simplex Type 2 （HSV-2） infected area and the cell-mediated immunity in genital herpes （GH） patients. Methods HSV-2 DNA from the lesions of 28 symptomatic GH patients was measured using FQ-PCR. The proportions of Th and Tc lymphoeytes in peripheral blood were determined by flow cytometry （FCM）. Linear-regression method was used to analyze the relationship between HSV-2 DNA loading and the proportions of Th and Tc lymphocytes. Results （1） The positive detection rate of HSV-2 DNA in lesions was 100%, and the average DNA copy number was （6 190 714±1 962 085） eopies/mL. The frequency of recurrence is positively correlated with the level of HSV-2 DNA in lesions. （2）The level of HSV-2 DNA in lesion was negatively correlated with the proportions of Thl, Tcl and the ratios of Thl/Th2 and Tel/Tc2, and positively correlated with the proportion of Th2 in peripheral blood of the symptomatic GH patients.Conclusion （1） A significant suppression of cell-mediated immunity was observed in GH patients. The HSV-2 virus loads in lesions are negatively correlated with the proportions of Thl, Tcl and the ratios of Th1/Th2 and Tc1/Tc2 in peripheral blood of the GH patients. （2）The suppression of cell-mediated immunity might be caused by the shift of subsets of T lymphocytes, reduction of NK cell and the imbalance of Th and Tc differentiation, thus facilitating the virus multiplication and recurrence of GH.