摘要
目的分析人类免疫缺陷病毒(Human immunodeficiency virus,HIV)阴性隐球菌性脑膜炎(Cryptococcal meningitis,CM)患者外周血淋巴细胞亚群改变特点,深化对隐球菌病发病机制的认识。方法筛选HIV阴性CM患者31例和健康献血员21例进行淋巴细胞亚群分析,CM患者根据是否存在免疫抑制基础疾病分为两个亚组,比较3组研究对象淋巴细胞亚群中B、NK、CD_4^+T、CD_8^+T细胞亚群,CD_4^+T及CD_8^+T细胞的第二信号受体CD28表达比例及CD_8^+T细胞激活标记物HLA-DR、CD38的表达水平。结果有基础病CM组B、NK、CD_4^+T和CD_8^+T 4种亚群中位数依次为56×10~6/L、86×10~6/L、218×10~6/L、164×10~6/L,显著低于健康对照组的223×10~6/L、280×10~6/L、695×10~6/L、521×10~6/L(P值均<0.001),同时存在CD_8^+T细胞激活亚群比例较健康对照显著升高。无基础病CM患者上述4种细胞亚群中位数依次为128×10~6/L、128×10~6/L、567×10~6/L、527×10~6/L,除CD_8^+T细胞计数水平与健康对照相似以外,B(P=0.02)、NK(P=0.002)和CD_4^+T细胞(P=0.03)计数均低于健康对照,其CD_8^+T细胞激活亚群比例与健康对照组相似。CD_4^+T和CD_8^+T细胞的CD28表达水平在3组间未见显著差异。结论 HIV阴性CM患者,无论是否存在免疫抑制基础疾病,外周血B、NK及CD_4^+T 3种细胞计数可出现同时减少。
Objective To find if immunophenotypic features of peripheral lymphocytes was associated with risk of crypto- coccal meningitis （CM） in HIV-negative individuals.Methods A total of 31 CM patients treated at a tertiary hospital in Bei- j ing,China were included.They were divided into immunocompromised comorbidity group （n = 16） and apparently immuno- competent group （n = 15）.Twenty-one healthy donors were included as control group.Lymphocyte subsets including B, NK, CD4 ＋ T,and CD8 ＋ T cells,CD28 expression on T cells,and activation markers （HLA-DR and CD38 ） on CD8 ＋ T cells were de- termined by flow cytometry and compared among the three groups.Results Compared with healthy donors,immunocompro- mised eomorbidity group had dramatically decreased median B cell （223 vs. 56μL）, NK cell （280 vs. 86μL）, CD4 ＋ T cell （695 vs.218μL）,and CD8＋ T cell （521 vs. 164μL） counts （P values for all four subsets〈0.001）.Proportions of activated CD8 ＋ T cells were significantly increased in immunocompromised patients than that in healthy control.Except for CD8 ＋ T cell counts （527μL） ,the median B cell （128μL,P=0.02） ,NK cell （128μL,P =0.002） and CD4＋ T cell （567μL,P =0.03） were moderately reduced in the apparently immunocompetent group than those in the healthy donors.The levels of HLA-DR and CI）38 on CD8 ＋ T cells in the apparently immunocompetent group were similar with the healthy donors.CD28 expression on CD4 ＋ T and CD8 ＋ T cells did not differ among the three groups.Conclusions The immunophenotype o{ CM patients with ira-munocompromised comorbidity was characterized by generalized decreased B, NK, CD4 ＋ T, and CD8 ＋ T cells.Mild-to-moderate reduce in B cell,NK cell and CD4 ＋T cell counts were observed in apparently im- munocompetent patients.
出处
《中国真菌学杂志》
CSCD
2017年第5期262-267,共6页
Chinese Journal of Mycology
基金
国家科技支撑计划课题(2014BAI07B06)
北京协和医院中青年科研基金(pumch-2016-2.3)
