间歇性应用免疫调节剂对亚临床型生殖器疱疹患者外周血淋巴细胞的影响
|
摘要
目的探讨影响亚临床型生殖器疱疹患者机体免疫水平的相关因素,以及予免疫调节剂治疗后机体免疫状态的改善情况。方法用荧光定量PCR检测患者带毒情况,用流式细胞仪检测患者的免疫功能。比较带毒阳性组与带毒阴性组,频发组(复发≥6次/年)与少发组(复发<6次/年)以及使用免疫调节剂治疗前后患者的外周血淋巴细胞百分比。结果带毒阳性组CD3~+,CD4~+,CD4~+/CD8~+T细胞均低于带毒阴性组,差异有统计学意义(P<0.05),频发组CD3~+,CD4~+,CD4~+/CD8~+,NK细胞均低于少发组,CD8~+T细胞高于少发组,差异有统计学意义(P<0.05),治疗组CD3~+,CD4~+,CD4~+/CD8~+,NK细胞均低于对照组,CD8~+T细胞高于对照组,差异有统计学意义(P<0.05),治疗后CD3~+,CD4~+,CD4~+/CD8~+,NK细胞均高于治疗前,CD8~+T细胞低于治疗前,差异有统计学意义(P<0.05),在各种分组情况下比较B细胞数值变化,差异无统计学意义(P>0.05)。结论亚临床型GH患者存在免疫功能低下的情况,带毒及频发患者的免疫抑制更为严重,而给予联合应用免疫调节剂后免疫低下较前改善。
Objective This study was to investigate the factors affecting immune status in patients with subclinical genital herpes,and the improvements in immune status after treatment with immunomodulators. Methods HSV viral carriers were identified using fluorescent quantitative polymerase chain reaction( q PCR). Flow cytometry was used to evaluate the patients' immune function. Percentages of peripheral blood lymphocytes were compared in HSV~+vs. HSV-,more( annual recurrence ≥6) vs. less( annual recurrence < 6) frequent recurrence,as well as before and after immunomodulator therapy. Results Lower percentages of CD3~+,CD4~+,CD4~+/CD8~+T cells were found in HSV~+group( P < 0. 05 vs. HSV-). Patients with more frequent recurrence showed significantly lower percentages of CD3~+,CD4~+,CD4~+/CD8~+,natural killer cells,and higher percentage of CD8~+T cells( P < 0. 05 vs. annual recurrence < 6). Patients in the treatment group displayed significantly lower percentages of CD3~+,CD4~+,CD4~+/CD8~+,natural killer cells,and higher percentage of CD8~+T cells in comparison with normal controls( P < 0. 05). Following the treatment,the proportions of CD3~+,CD4~+,CD4~+/CD8~+,natural killer cells increased while the proportion of CD8~+T cells decreased( P < 0. 05 vs. pre-treatment). There were no significant differences in B cells in all groups( P >0. 05). Conclusion Patients with subclinical genital herpes exhibit compromised immunity. Patients with HSV~+or more frequent recurrence display severe immunosuppression. Treatment with combination of immunomodulators can improve immune function in HSV~+patients.
Objective This study was to investigate the factors affecting immune status in patients with subclinical genital herpes,and the improvements in immune status after treatment with immunomodulators. Methods HSV viral carriers were identified using fluorescent quantitative polymerase chain reaction( q PCR). Flow cytometry was used to evaluate the patients' immune function. Percentages of peripheral blood lymphocytes were compared in HSV~+vs. HSV-,more( annual recurrence ≥6) vs. less( annual recurrence < 6) frequent recurrence,as well as before and after immunomodulator therapy. Results Lower percentages of CD3~+,CD4~+,CD4~+/CD8~+T cells were found in HSV~+group( P < 0. 05 vs. HSV-). Patients with more frequent recurrence showed significantly lower percentages of CD3~+,CD4~+,CD4~+/CD8~+,natural killer cells,and higher percentage of CD8~+T cells( P < 0. 05 vs. annual recurrence < 6). Patients in the treatment group displayed significantly lower percentages of CD3~+,CD4~+,CD4~+/CD8~+,natural killer cells,and higher percentage of CD8~+T cells in comparison with normal controls( P < 0. 05). Following the treatment,the proportions of CD3~+,CD4~+,CD4~+/CD8~+,natural killer cells increased while the proportion of CD8~+T cells decreased( P < 0. 05 vs. pre-treatment). There were no significant differences in B cells in all groups( P >0. 05). Conclusion Patients with subclinical genital herpes exhibit compromised immunity. Patients with HSV~+or more frequent recurrence display severe immunosuppression. Treatment with combination of immunomodulators can improve immune function in HSV~+patients.
引文
[1]Kortekangas-Savolainen O,Orhanen E,Puodinketo T,et al.Epidemiology of genital herpes simplex virus type1 and 2 infection in southwestern Finland during a 10-year period(2003-2012)[J].Sex Transm Dis,2014,41(4):268-271.
[2]Johnston C,Corey L.Current Concepts for Genital Herpes Simplex Virus Infection:Diagnostics and Pathogenesis of Genital Tract Shedding[J].Clin Microbiol Rev,2016,29(1):149-161.
[3]吴健,贾国泉,吴瑞斌,等.复发性生殖器疱疹患者外周血T淋巴细胞和共刺激分子的检测[J].中国皮肤性病学杂志,2010,24(12):1113-4,1124.
[4]Long D,Skoberne M,Gierahn TM,et al.Identification of novel virus-specific antigens by CD4+and CD8+T cells from asymptomatic HSV-2seropositive and seronegative donors[J].Virology,2014,464-465(9):296-311.
[5]刘若缨,虢周科,杨曙东,等.复发性生殖器疱疹患者的精神抑郁症状与细胞免疫功能的关系研究[J].中国中西医结合皮肤性病学杂志,2006,5(1):23-25.
[6]Phipps W,Nakku-Joloba E,Krantz EM,et al.Genital herpes simplex virus type 2 shedding among adults with and without HIV infection in Uganda[J].J Infect Dis,2016,213(3):439-447.
[7]Shannon B,Yi TJ,Thomas-Pavanel J,et al.Impact of asymptomatic herpes simplex virus type 2 infection on mucosal homing and immune cell subsets in the blood and female genital tract[J].J Immunol,2014,192(11):5074-5082.
[8]莫翔,韦又铭.复发性生殖器疱疹患者免疫细胞功能研究进展[J].医学综述,2012,18(15):2385-2387.
[9]李慧,王永军,孙进.匹多莫德及其制剂的研究进展[J].中国药剂学杂志(网络版),2012,10(4):68-73.
[10]林兰,刘建文.胸腺肽制剂及临床应用研究现状[J].中国药事,2009,23(7):706-9,717.
[11]李志虎.甘露聚糖肽对细胞因子诱导的杀伤细胞的活性的影响[D].兰州:兰州大学,2013:1-32.
[2]Johnston C,Corey L.Current Concepts for Genital Herpes Simplex Virus Infection:Diagnostics and Pathogenesis of Genital Tract Shedding[J].Clin Microbiol Rev,2016,29(1):149-161.
[3]吴健,贾国泉,吴瑞斌,等.复发性生殖器疱疹患者外周血T淋巴细胞和共刺激分子的检测[J].中国皮肤性病学杂志,2010,24(12):1113-4,1124.
[4]Long D,Skoberne M,Gierahn TM,et al.Identification of novel virus-specific antigens by CD4+and CD8+T cells from asymptomatic HSV-2seropositive and seronegative donors[J].Virology,2014,464-465(9):296-311.
[5]刘若缨,虢周科,杨曙东,等.复发性生殖器疱疹患者的精神抑郁症状与细胞免疫功能的关系研究[J].中国中西医结合皮肤性病学杂志,2006,5(1):23-25.
[6]Phipps W,Nakku-Joloba E,Krantz EM,et al.Genital herpes simplex virus type 2 shedding among adults with and without HIV infection in Uganda[J].J Infect Dis,2016,213(3):439-447.
[7]Shannon B,Yi TJ,Thomas-Pavanel J,et al.Impact of asymptomatic herpes simplex virus type 2 infection on mucosal homing and immune cell subsets in the blood and female genital tract[J].J Immunol,2014,192(11):5074-5082.
[8]莫翔,韦又铭.复发性生殖器疱疹患者免疫细胞功能研究进展[J].医学综述,2012,18(15):2385-2387.
[9]李慧,王永军,孙进.匹多莫德及其制剂的研究进展[J].中国药剂学杂志(网络版),2012,10(4):68-73.
[10]林兰,刘建文.胸腺肽制剂及临床应用研究现状[J].中国药事,2009,23(7):706-9,717.
[11]李志虎.甘露聚糖肽对细胞因子诱导的杀伤细胞的活性的影响[D].兰州:兰州大学,2013:1-32.