活化型血小板-CD4细胞聚合体与HIV/AIDS患者免疫状态的关系
The relationship between activated platelet-CD4+T cell aggregates and the immune status of HIV/AIDS patients
蒋梅青 1王芯栎 1赵萌 2杜娟 1赵红心 3孔雅娴2
作者信息
- 1. 首都医科大学附属北京地坛医院,北京 100015;首都医科大学附属北京地坛医院传染病研究所新发突发传染病研究北京市重点实验室,北京 100015;北京市感染性疾病研究中心,北京 100015;国家传染病医学中心 首都医科大学附属北京地坛医院,北京 100015;传染病溯源预警与智能决策全国重点实验室,北京 100015
- 2. 首都医科大学附属北京地坛医院,北京 100015;首都医科大学附属北京地坛医院传染病研究所新发突发传染病研究北京市重点实验室,北京 100015;北京市感染性疾病研究中心,北京 100015;国家传染病医学中心 首都医科大学附属北京地坛医院,北京 100015;传染病溯源预警与智能决策全国重点实验室,北京 100015;北京大学地坛医院教学医院,北京 100015
- 3. 首都医科大学附属北京地坛医院,北京 100015;首都医科大学附属北京地坛医院艾滋病临床中心,北京 100015
- 折叠
摘要
目的 分析HIV/AIDS患者不同疾病状态下外周血中CD4细胞与活化血小板形成聚合体的比例变化,并探讨活化型血小板-CD4细胞聚合体聚集的原因及与疾病进展的关系.方法 入组符合标准的100例未经cART的HIV/AIDS患者(TN),18例经cART治疗后的免疫应答(IR)者,13例免疫无应答(INR)者与20例健康对照(HC).利用流式细胞术检测活化型血小板-CD4细胞聚合体的比例和血小板及CD4细胞的自身活化程度,探究活化型血小板-CD4细胞聚合体比例变化特点、与疾病进展的关系以及参与聚合体形成的影响因素.结果 TN组活化型血小板-CD4细胞聚合体比例显著升高(TN vs.HC:中位数6.420vs.5.200,Z=2.093,P=0.033 2),且该比例与CD4细胞计数、CD4/CD8细胞比值呈显著负相关(CD4细胞计数,r=-0.553 0,P＜0.000 1;CD4/CD8细胞比值,r=-0.601 5,P＜0.000 1),与病毒载量呈显著正相关(r=0.329 8,P=0.001 0).经cART后,IR组较TN组活化型血小板-CD4细胞聚合体比例显著降低(IR vs.TN:中位数4.535 vs.6.420,Z=2.776,P=0.005 3),而INR组未见降低(INRvs.TN:中位数6.730 vs.6.420,Z=0.654 2,P=0.511 2).TN组外周血中活化型血小板-CD4细胞聚合体比例与HLA-DR+CD4+T细胞比例呈正相关(r=0.426 2,P=0.005 5),而与血小板计数及血小板活化水平无相关性.结论 活化型血小板-CD4细胞聚合体比例与HIV/AIDS患者疾病进程及cART效果密切相关,且该聚合体的形成主要受CD4细胞自身活化程度影响.
Abstract
Objective To explore the proportion of activated platelet-CD4+T cell aggregates in the peripheral blood of HIV/AIDS patients in different disease states,and to investigate the reasons for the aggregation of activated platclct-CD4+cell aggregates and their relationship with disease progression.Methods A cohort of 100 treatment-naïve HIV/AIDS patients(TN),18 immunological responders(IR)post-combination antiretroviral therapy(cART),13 immunological non-responders(INR),and 20 healthy controls(HC)were enrolled.Flow cytometry was used to determine the proportion of activated platelet-CD4+T cell aggregates and the self-activation levels in both platelets and CD4+T cells,with the aim of investigating changes in the proportion of activated platelet-CD4+T cell aggregates,their relationship with disease progression,and the influencing factors involved in aggregate formation.Results The proportion of activated platelet-CD4+T cell aggregates was significantly higher in the TN group(TN vs.HC:median 6.420 vs.5.200,Z=2.093,P=0.033 2),and this proportion was negatively correlated with CD4+T cell count and the CD4+/CD8+ratio(CD4+T count,r=-0.553 0,P＜O.OO0 1;CD4+/CD8+ratio,r=-0.601 5,P＜0.000 1),and positively correlated with viral load(r=0.329 8,P=0.001 0).After cART,the proportion of activated platelet-CD4+T cell aggregates was significantly lower in the IR group than in the TN group(IR vs.TN:median 4.535 vs.6.420,Z=2.776,P=0.005 3),whereas no reduction was observed in the INR group(INR vs.TN:median 6.730 vs.6.420,Z=0.654 2,P=0.511 2).The proportion of activated platelet-CD4+T cell aggregates in the peripheral blood of the TN group was positively correlated with the proportion of HLA-DR+CD4+T cells(r=0.426 2,P=0.005 5),but showed no correlation with the platelet count and platelet activation level.Conclusions The proportion of activated platelet-CD4+T cell aggregates is closely related to the disease progression in HIV/AIDS patients and the efficacy of cART,and the formation of these aggregates is primarily influenced by the activation level of CD4+T cells.
关键词
1型艾滋病病毒/活化血小板-CD4细胞聚合体/血小板/CD4细胞Key words
HIV-1/activated platelet-CD4+T cell aggregates/platelet/CD4+T cells引用本文复制引用
基金项目
北京市杰出青年科学基金(JQ21023)
北京市高层次公共卫生技术人才建设项目(学科骨干-02-27)
北京市医管中心项目(DFL20191802)
北京市医院管理局临床医学发展专项(扬帆计划)(ZYLX202126)
出版年
2024
NETL
NSTL
万方数据