Li Tai-Sheng, Qin Hai-Yan, Chen Hu, Jiang Min, Wang Huan-Ling, Wang Ai-Xia
Department of Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
Zhonghua Nei Ke Za Zhi. 2003 Jun;42(6):396-9.
To study the alterations and the clinical significance of peripheral lymphocyte subsets in patients with active cytomegalovirus (CMV) infection during the early stage of allogeneic peripheral blood stem cell transplantation (PBSCT) and to investigate the influence of active CMV infection on immunity.
K(3)-EDTA anticoagulated peripheral blood samples were collected weekly from 27 allogeneic PBSCT recipients in the first 3 months after PBSCT. CMV pp65 antigen in peripheral white blood cells were tested by indirect immunofluorescence assay, and lymphocyte subsets were detected by flow cytometry with specific fluorescent monoclonal antibodies. In the meantime lymphocyte subsets of 51 samples from healthy blood donors were tested as normal control values.
CD(4)(+) T cell count for all recipients was significantly low throughout the first 3 months after PBSCT as compared with normal donors (P < 0.01). Of the 27 allogeneic PBSCT recipients, 5 had no active CMV infection, 10 had asymptomatic CMV active infection, 12 had symptomatic CMV infection. The average CD(4)(+) T cell counts (x 10(6)/L) for the different groups of patients were 328 +/- 203, 239 +/- 218 and 199 +/- 92; The average CD(8)(+) T cell counts (x 10(6)/L) were 400 +/- 380, 267 +/- 206 and 603 +/- 461, respectively. The average percentage of CD(4)(+) CD(28)(+) T cell subsets were (89.2 +/- 8.9)%, (84.2 +/- 10.1)% and (63.5 +/- 11.4)%, respectively. The recipients with asymptomatic CMV active infection were likely to have more natural killer (NK) cells as compared with those without active CMV infection (P < 0.01). The patients with symptomatic CMV infection had significantly lower CD(4)(+) cell count and higher CD(8)(+) cell count than those with asymptomatic CMV infection (P < 0.01). The percentage of CD(4)(+) CD(28)(+) cells was decreased significantly in the CMV active infection group (P < 0.01).
CMV active infection could induce dramatic alterations in lymphocyte subsets lymphocyte subsets and host immunity for allogeneic PBSCT recipients. Therefore, the changes of lymphocyte subsets might serve as auxiliary parameters to predict active CMV infections in this kind of immunocompromised patients.
研究异基因外周血干细胞移植（PBSCT）早期活动性巨细胞病毒（CMV）感染患者外周血淋巴细胞亚群的变化及其临床意义，并探讨活动性CMV感染对免疫功能的影响。
对27例异基因PBSCT受者在PBSCT后的前3个月每周采集K(3)-EDTA抗凝外周血样本。采用间接免疫荧光法检测外周血白细胞中的CMV pp65抗原，并用特异性荧光单克隆抗体通过流式细胞术检测淋巴细胞亚群。同时检测51例健康献血者样本的淋巴细胞亚群作为正常对照值。
与正常供者相比，所有受者在PBSCT后的前3个月内CD(4)(+) T细胞计数均显著降低（P < 0.01）。27例异基因PBSCT受者中，5例无活动性CMV感染，10例有无症状CMV活动性感染，12例有症状性CMV感染。不同组患者的平均CD(4)(+) T细胞计数（×10(6)/L）分别为328±203、239±218和199±92；平均CD(8)(+) T细胞计数（×10(6)/L）分别为400±380、267±206和603±461。CD(4)(+) CD(28)(+) T细胞亚群的平均百分比分别为(89.2±8.9)%、(84.2±10.1)%和(63.5±11.4)%。与无活动性CMV感染的受者相比，有无症状CMV活动性感染的受者可能有更多的自然杀伤（NK）细胞（P < 0.01）。有症状性CMV感染的患者比无症状CMV感染的患者CD(4)(+)细胞计数显著降低，CD(8)(+)细胞计数显著升高（P < 0.01）。CMV活动性感染组CD(4)(+) CD(28)(+)细胞的百分比显著降低（P < 0.01）。
CMV活动性感染可导致异基因PBSCT受者淋巴细胞亚群和宿主免疫功能发生显著变化。因此，淋巴细胞亚群的变化可作为预测这类免疫功能低下患者活动性CMV感染的辅助参数。
