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目的探讨高效抗反转录病毒疗法(highly active antiretroviral treatment,HAART)治疗24周AIDS患者外周血程序性死亡因子(programmed death-1,PD-1)和配体(Programmed cell death 1 ligand l,PD-L1)表达水平的特点变化。方法选取HAART治疗的45例艾滋病感染者(AIDS),按CD+4T细胞计数分成1~100 cells/μl、101~200cells/μl和201~350 cells/μl三组,于抗病毒前和抗病毒24周时采集静脉血,同时选取21名健康体检者作对照。运用流式细胞仪检测外周血中CD+4T细胞表面PD-1和PD-L1的表达水平,实时荧光定量PCR仪检测血浆病毒载量,数据处理采用t检验,相关性分析采用Pearson相关。结果 AIDS感染者治疗前PD-1/PD-L1的表达频率为(1.16±0.26)%和(0.63±0.140)%,均显著高于健康对照组(t分别为6.31和4.27,P=0.000)。抗病毒治疗24周时PD-1/PD-L1在CD+4T细胞中的表达频率分别为(0.76±0.14)%和(0.52±0.06)%,与治疗前相比PD-1表达水平显著下降(t=3.77,P=0.000),PD-L1的表达频率也有所下降,但差异无统计学意义(t=1.78,P=0.056)。CD+4T细胞基数为201~350 cells/μl患者组其PD-1表达频率在治疗24周后平均下调率明显高于另二组(38.54%vs.25.66%和23.77%),而PD-L1的表达也高于1~100 cells/μl和101~200 cells/μl二组(18.97%vs 15.87%和12.31%)。治疗前与治疗后AIDS感染者CD+4T细胞数与PD-1表达百分率呈显著负相关(r=-0.434,-0.317,P=0.009和0.031),与病毒载量呈显著正相关(r分别为0.499和0.319,P为0.0049和0.032)。PD-L1表达频率在治疗前与治疗后与CD+4T细胞数呈显著负相关(r=-0.454和-0.314,P=0.002和0.012),与病毒载量在治疗前后呈显著正相关(r=0.513和0.428,P=0.000和0.004)。结论 AIDS感染者外周血PD-1/PD-L1的表达水平增加,且与疾病进展密切相关。
Objective To investigate the effects of highly active antiretroviral treatment (HAART) on programmed death cell death 1 (PD) 1 and PD -L1) expression changes in the characteristics. Methods AIDS patients were treated with HAART and divided into three groups (1 ~ 100 cells / μl, 101 ~ 200 cells / μl and 201 ~ 350 cells / μl) according to the count of CD + Venous blood was collected at 24 weeks and 21 healthy controls were selected as controls. Flow cytometry was used to detect the expression of PD-1 and PD-L1 on peripheral blood CD + 4 T cells. Real-time PCR was used to detect the plasma viral load. The data were analyzed by t-test and Pearson correlation. Results The frequency of PD-1 / PD-L1 expression in patients with AIDS was (1.16 ± 0.26)% and (0.63 ± 0.140)% respectively, which were significantly higher than those in healthy controls (t = 6.31 and 4.27, P = 0.000) . The frequency of PD-1 / PD-L1 expression in CD + 4T cells was (0.76 ± 0.14)% and (0.52 ± 0.06)% respectively at 24 weeks after antivirus treatment, (t = 3.77, P = 0.000). The frequency of PD-L1 expression also decreased, but the difference was not statistically significant (t = 1.78, P = 0.056). The average down-regulation of PD-1 expression in patients with CD + 4T cell population of 201-350 cells / μl was significantly higher than that of the other two groups (38.54% vs.25.66% and 23.77% (18.97% vs 15.87% and 12.31%) in the two groups of 1 ~ 100 cells / μl and 101 ~ 200 cells / μl, respectively. There was a significant negative correlation between the number of CD + 4T cells and the percentage of PD-1 in AIDS-infected patients before and after treatment (r = -0.434, -0.317, P = 0.009 and 0.031, respectively) 0.499 and 0.319, P is 0.0049 and 0.032). The frequency of PD-L1 expression was negatively correlated with the number of CD + 4T cells before and after treatment (r = -0.454 and -0.314, P = 0.002 and 0.012, respectively), and had significant positive correlation with viral load before and after treatment = 0.513 and 0.428, P = 0.000 and 0.004). Conclusion The expression level of PD-1 / PD-L1 in peripheral blood of AIDS-infected patients increases, which is closely related to the progress of the disease.