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目的比较中国儿童及成人艾滋病(AIDS)患者的免疫活化水平。方法以103例儿童AIDS患者、38例成人AIDS患者、88名健康儿童和72名健康成人为研究对象,取抗凝血进行流式细胞计数检测CD4+T细胞数,荧光定量RT-PCR测定血清HIV-RNA滴度,采用ELISA法检测血清中Th1/Th2免疫因子(IL-10、IL-16、IL-18)、趋化因子[包括调节活化正常T细胞表达与分泌的趋化因子(RANTES)、单核细胞趋化蛋白1(MCP-1)、基质细胞衍生因子1(SDF-1)]及巨噬细胞刺激蛋白(MSP)的水平,并以β2微球蛋白(β2-MG)和可溶性Fas(sFas)的表达水平作为机体免疫活化指标。结果儿童AIDS患者组的CD4+T细胞数显著低于儿童正常对照组(P<0.01),各细胞因子水平较儿童正常对照组显著升高(P均<0.01)。成人AIDS患者组的CD4+T细胞数显著低于成人正常对照组(P<0.01),除MSP水平显著低于成人对照组(P<0.01)外,其余各细胞因子均显著高于成人对照组(P<0.01)。儿童AIDS患者组各因子水平除SDF-1α和β2-MG与成人AIDS患者组差异无显著性(P>0.05)外,其余均显著高于成人AIDS患者组(P<0.01)。结论儿童和成人AIDS患者的免疫系统均表现为明显的异常活化,儿童患者的免疫活化水平高于成人患者。
Objective To compare the immune activation of AIDS patients in Chinese children and adults. Methods A total of 103 children with AIDS, 38 adults with AIDS, 88 healthy children and 72 healthy adults were enrolled in this study. The number of CD4 + T cells was determined by flow cytometry (FCM). The serum levels of CD4 The serum levels of Th1 / Th2 immune factors (IL-10, IL-16, IL-18) and chemokines [including those regulating the expression and secretion of activated normal T cells (RANTES ), Monocyte chemoattractant protein 1 (MCP-1), stromal cell-derived factor 1 (SDF-1) and macrophage stimulating protein (MSP) Soluble Fas (sFas) expression levels as indicators of immune activation. Results The number of CD4 + T cells in children with AIDS was significantly lower than that in children (P <0.01). The levels of cytokines in children with AIDS were significantly higher than those in children (all P <0.01). The number of CD4 + T cells in adult AIDS patients was significantly lower than that in adult controls (P <0.01). Except for MSP, which was significantly lower than that in adult controls (P <0.01), all other cytokines were significantly higher than those in adult controls (P <0.01). The level of each factor in children with AIDS was significantly higher than that in adults with AIDS except SDF-1α and β2-MG and adults with AIDS (P <0.01). Conclusion Both immune system in children and adults with AIDS show obvious abnormal activation, and the immune activation in children is higher than that in adults.