光动力治疗对尖锐湿疣患者外周血CD4+CD25+CD127dim调节性T细胞的影响
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摘要
目的探讨光动力(ALA-PDT)治疗对尖锐湿疣(CA)患者外周血CD4+CD25+CD127dim调节性T细胞(Treg)的影响。方法观察3次治疗结束后皮损消退情况,皮疹消退者进入3个月观察期试验,即观察皮疹复发情况及每月测定1次外周血Treg细胞比值。结果 187例CA患者(初发102例、复发85例)在第1次ALA-PDT治疗前及连续3次ALA-PDT治疗后分别用流式细胞仪进行外周血Treg细胞比值的检测;30例健康体检者作为对照组。CA患者外周血Treg比值明显高于健康对照组,且复发组高于初发组,差异有统计学意义(P均<0.05)。ALA-PDT治疗后CA患者因皮疹减少或消退,外周血Treg比值逐渐下降(P<0.05)。观察期皮疹第1次复发患者,Treg比值逐渐升高,且均高于同期未复发患者及健康对照组(P均<0.05)。3次ALA-PDT治疗后疣体全部消退患者占比70.59%,观察期3个月结束后疣体第1次复发患者占比28.03%。结论 Treg比值的高低与CA患者发病、复发密切相关;ALA-PDT治疗可通过改变CA患者皮疹状况间接影响Treg比值;3次ALA-PDT治疗可有效去除疣体,但复发问题需引起重视。
Objective To evaluate the effect of ALA-PDT therapy on CD4+CD25+CD127 dim regulatory T cells(Treg) in peripheral blood of patients with condyloma acuminatum(CA). Methods 187 patients with CA(including 102 cases with first onset and 85 cases with recurrence)were selected as an experimental group and given three times of ALA-PDT therapies. 30 healthy controls examined in our hospital at the same time were selected as healthy control group. Venous blood samples were obtained from all the patients before and after every time of ALA-PDT therapies, as well as from the patients in the observation period of three months and 30 healthy controls. The percentage of peripheral Treg cells in CD4+T lymphocytes was determined by flow cytometry. The disappearance and recurrence of CA was evaluated in the whole experimental process. Results The percentage of peripheral Treg cells in CD4~+T lymphocytes was significantly higher of patients with CA than that of the controls, which was higher of the relapsing patients than that of the first onset patients too. The percentage of peripheral Treg cells in CD4+T lymphocytes significantly declined after three times of ALA-PDT therapies with the diminishment and extinction of CA, and however went up higher again during the three months of observation period of the patients with first recurrent CA than that of the patients without recurrent CA and that of the healthy controls. The percentage of patients without CA after three times of ALA-PDT therapies was 70.59%, and the percentage of patients with first recurrent CA was 28.03% after three months of observation. Conclusion The percentage of Treg cells has a close relationship with the occurrence and recurrence of CA; the effect of ALA-PDT therapy on Treg may be achieved indirectly by the diminishment and extinction of CA; three times of ALA-PDT therapies can remove CA effectively. However, we should pay more attention to the recurrence.
Objective To evaluate the effect of ALA-PDT therapy on CD4+CD25+CD127 dim regulatory T cells(Treg) in peripheral blood of patients with condyloma acuminatum(CA). Methods 187 patients with CA(including 102 cases with first onset and 85 cases with recurrence)were selected as an experimental group and given three times of ALA-PDT therapies. 30 healthy controls examined in our hospital at the same time were selected as healthy control group. Venous blood samples were obtained from all the patients before and after every time of ALA-PDT therapies, as well as from the patients in the observation period of three months and 30 healthy controls. The percentage of peripheral Treg cells in CD4+T lymphocytes was determined by flow cytometry. The disappearance and recurrence of CA was evaluated in the whole experimental process. Results The percentage of peripheral Treg cells in CD4~+T lymphocytes was significantly higher of patients with CA than that of the controls, which was higher of the relapsing patients than that of the first onset patients too. The percentage of peripheral Treg cells in CD4+T lymphocytes significantly declined after three times of ALA-PDT therapies with the diminishment and extinction of CA, and however went up higher again during the three months of observation period of the patients with first recurrent CA than that of the patients without recurrent CA and that of the healthy controls. The percentage of patients without CA after three times of ALA-PDT therapies was 70.59%, and the percentage of patients with first recurrent CA was 28.03% after three months of observation. Conclusion The percentage of Treg cells has a close relationship with the occurrence and recurrence of CA; the effect of ALA-PDT therapy on Treg may be achieved indirectly by the diminishment and extinction of CA; three times of ALA-PDT therapies can remove CA effectively. However, we should pay more attention to the recurrence.
引文
[1] 梁艳华,毕超,梁景辉,等.不同病程尖锐湿疣患者HPV感染和淋巴细胞免疫功能分析[J].中国艾滋病性病,2017,23(12):1138-1140.
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[15] 张恒坡,曹冰青,尹光文,等.5-氨基酮戊酸光动力诊断在尖锐湿疣随访中的应用[J].中国艾滋病性病,2018,24(4):410-412.
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[19] 李惠,赵学良,程芳.人乳头瘤病毒持续感染者与一过性感染者外周血CD4+和CD25+和Foxp3+调节性T细胞的变化[J].皮肤性病诊疗学杂志,2017,24(3):181-183,187.
[20] Bu ZY,Yu XH,Wu LM,et al.Normalization of regulatory T cells,serum TGF-β,and LTN after 5-aminolevulinic acid-photodynamic therapy in patients with condyma acuminate[J].Experimental and therapeutic medicine,2017,13(6):3327-3332.
[21] 王香春,昌玲,石年.复发性尖锐湿疣患者光动力联合二氧化碳激光治疗效果及其对患者外周血T细胞亚群和调节性T细胞的影响[J].中国性科学,2018,27(4):44-47.
[22] 张玉.光动力疗法与CO2激光对尖锐湿疣患者细胞免疫功能的影响[J].标记免疫分析与临床,2017,24(2):210-213.
[23] 刘艳荣主编.实用流式细胞术—血液病篇[M].北京:北京大学医学出版社,2010年.
[24] 李志锋,李小静,李立红,等.光动力联合二氧化碳激光对复发性尖锐湿疣患者外周血CD4+、CD8+T细胞和调节性T细胞表达的影响[J].中国医药导报,2016,13(23):138-141.
[25] Sch?fer H,Tatti S,Lynde CW,et al.Sinecatechins and imiquimod as proactive sequential therapy of external genital and perianal warts in adults[J].International journal of STD & AIDS,2017,28(14):1433-1443.
[2] 叶丽,林旗.复发性尖锐湿疣患者T细胞改变和人乳头瘤病毒感染分型分析[J].国际流行病学传染病学杂志,2018,45(2):98-102.
[3] 苏鑫,孙琳.GARP+调节性T细胞及其部分疾病关系的研究进展[J].细胞与分子免疫学杂志,2017,33(3):410-413.
[4] Altmann DM.Regulatory T-cells:receptors,repertoires and roles in disease[J].Immunology,2018,155 (2):153-154.
[5] 中华医学会皮肤性病学分会性病学组.尖锐湿疣治疗专家共识(2017)[J].临床皮肤科杂志,2018,47(2):125-127.
[6] 岳晓丽,龚向东,李婧,等.2008—2016年中国性病监测点尖锐湿疣流行特征分析[J].中华皮肤科杂志,2017,50(5):321-325.
[7] Xie Z,Zhang M,Xiong W,et al.Immunotolerant indoleamine-2,3-dioxygenase is increased in condyloma acuminate[J].Br J Dermatol,2017,177(3):809-817.
[8] Yin GW,Guo Y,Jin B.Expressions of NDRG1,VEGF and Ki-67 in Condylar Acuminatum[J].J Biol Regul Homeost Agents,2016,Jul-Sep (3):773-776.
[9] Yin GW,Guo Y,Huang YH,et al.The expression and significance of XIAP and C-jun on Condyloma acuminatum[J].Pak J Pharm Sci,2015,28(4 Suppl):1551-1553.
[10] 许小容,陈永艳.尖锐湿疣患者外周血IL-17、IL-23 IL-10和TGF-β表达水平[J].中国艾滋病性病,2018,24(7):711-713.
[11] Yin G,Sha K,Cai B,et al.Effect of 5-aminolevulinic acid photodynamic therapy on keratinocyte proliferation and apoptosis in condylar acuminatum[J].Photodiagnosis Photodyn Ther,2017,Jun (18):310-314.
[12] Du J,Cheng Q,Zhang Z,et al.5-Aminolevulinic acid photodynamic therapy stimulates local immunity in patients with condylomata acuminate via activation of T lymphocytes[J].European review for medical and pharmacological sciences,2017,21(5):1125-1135.
[13] Zhang Z,Lu XN,Liang J,et al.Evaluation of photodynamic therapy using topical aminolevulinic acid hydrochloride in the treatment of condylomata acuminate[J].Int J Clin Exp Med,2015,8(4):6517-6521.
[14] Ao C,Xie J,Wang L,et al.5-aminolevulinic acid photodynamic therapy for anal canal condyloma acuminatum:A series of 19 cases and literature review[J].Photodiagnosis Photodyn Ther,2018,Sep (23):230-234.
[15] 张恒坡,曹冰青,尹光文,等.5-氨基酮戊酸光动力诊断在尖锐湿疣随访中的应用[J].中国艾滋病性病,2018,24(4):410-412.
[16] 王相华,李冬芹,张金凤,等.Th1/Th2/Th17/Treg平衡在特应性皮炎中的变化规律[J].中国皮肤性病学杂志,2018,32(5):503-506.
[17] Quiros-Roldan E,Zanini B,Ferraresi A,et al.Peripheral loss of regulatory T cells and polyautoimmunity in an HIV-infected patient[J].International journal of STD & AIDS,2018,29 (13):1345-1347.
[18] El-Maraghy N,Ghaly MS,Dessouki O,et al.CD4+CD25-Foxp3+ T cells as a marker of disease activity and organ damage in systemic lupus erythematosus patients[J].Archives of medical science,2018,14(5):1033-1040.
[19] 李惠,赵学良,程芳.人乳头瘤病毒持续感染者与一过性感染者外周血CD4+和CD25+和Foxp3+调节性T细胞的变化[J].皮肤性病诊疗学杂志,2017,24(3):181-183,187.
[20] Bu ZY,Yu XH,Wu LM,et al.Normalization of regulatory T cells,serum TGF-β,and LTN after 5-aminolevulinic acid-photodynamic therapy in patients with condyma acuminate[J].Experimental and therapeutic medicine,2017,13(6):3327-3332.
[21] 王香春,昌玲,石年.复发性尖锐湿疣患者光动力联合二氧化碳激光治疗效果及其对患者外周血T细胞亚群和调节性T细胞的影响[J].中国性科学,2018,27(4):44-47.
[22] 张玉.光动力疗法与CO2激光对尖锐湿疣患者细胞免疫功能的影响[J].标记免疫分析与临床,2017,24(2):210-213.
[23] 刘艳荣主编.实用流式细胞术—血液病篇[M].北京:北京大学医学出版社,2010年.
[24] 李志锋,李小静,李立红,等.光动力联合二氧化碳激光对复发性尖锐湿疣患者外周血CD4+、CD8+T细胞和调节性T细胞表达的影响[J].中国医药导报,2016,13(23):138-141.
[25] Sch?fer H,Tatti S,Lynde CW,et al.Sinecatechins and imiquimod as proactive sequential therapy of external genital and perianal warts in adults[J].International journal of STD & AIDS,2017,28(14):1433-1443.