Jin Chang-zhong, Zhao Yan, Zhang Fu-jie, Yao Hang-ping, Wu Ling-jiao, Zhao Hong-xin, Wei Hong-shan, Wu Nan-ping
First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Chin Med J (Engl). 2009 Mar 5;122(5):530-5.
The immunological differences between children and adults with AIDS in China are not well documented. Th1/Th2 cytokines and chemokines are two types of immune factors intimately involved in disease progression of HIV-1 infection. This study aimed to identify changes in plasma levels of Th1/Th2 cytokines inerleukin (IL)-18, IL-16, IL-10 and chemokines regulated on activation, normal T cell expressed and secreted (RANTES), stromal cell-derived factor-1 (SDF-1) and monocyte chemoattractant protein-1 (MCP-1) in HIV-1-infected children and adults in China.
Seventy-five children with AIDS and 35 adult AIDS patients were recruited and clinical data were collected. CD4(+) T lymphocyte counts were measured by flow cytometery and plasma HIV RNA levels were measured by quantitative RT-PCR. Plasma levels of IL-18, IL-10, IL-16, RANTES, MCP-1, SDF-1alpha and SDF-1beta were quantified by enzyme-linked immunosorbent assay. The levels of beta2-microglobulin (beta2-MG) and soluble Fas (sFas) were measured to validate the level of humoral and cellular immune activation.
The mean levels of all cytokines in pediatric and adult AIDS patients were significantly higher than in their healthy controls (P < 0.01). The mean levels of these cytokines were higher in pediatric patients than in adult patients (P < 0.05, except for SDF-1alpha and beta2-MG). Some of the cytokine levels in patients younger than 6 years old was higher than in older children and adults with AIDS (IL-10, IL-18, SDF-1alpha, MCP, RANTES and sFas, P < 0.05). Levels of IL-18, IL-10, RANTES and beta2-MG of pediatric patients increased as the levels of viral load increased (P < 0.05).
Abnormal immune activation can be measured in Chinese pediatric and adult patients with AIDS, and is higher in children than in adult patients. The cytokines levels coincide with disease progression of AIDS, but have no direct relationship with total CD4(+) T cell count.
中国儿童和成人艾滋病患者之间的免疫差异尚无充分记录。Th1/Th2细胞因子和趋化因子是两类与HIV-1感染疾病进展密切相关的免疫因子。本研究旨在确定中国HIV-1感染儿童和成人血浆中Th1/Th2细胞因子白细胞介素（IL）-18、IL-16、IL-10以及在激活状态下调节、正常T细胞表达和分泌的趋化因子（RANTES）、基质细胞衍生因子-1（SDF-1）和单核细胞趋化蛋白-1（MCP-1）水平的变化。
招募75名儿童艾滋病患者和35名成人艾滋病患者，并收集临床数据。通过流式细胞术检测CD4(+) T淋巴细胞计数，通过定量逆转录聚合酶链反应检测血浆HIV RNA水平。采用酶联免疫吸附测定法定量检测血浆中IL-18、IL-10、IL-16、RANTES、MCP-1、SDF-1α和SDF-1β的水平。检测β2-微球蛋白（β2-MG）和可溶性Fas（sFas）水平以验证体液免疫和细胞免疫激活水平。
儿童和成人艾滋病患者所有细胞因子的平均水平均显著高于其健康对照（P < 0.01）。这些细胞因子的平均水平在儿童患者中高于成人患者（P < 0.05，SDF-1α和β2-MG除外）。6岁以下患者的某些细胞因子水平高于年龄较大的儿童和成人艾滋病患者（IL-10、IL-18、SDF-1α、MCP、RANTES和sFas，P < 0.05）。儿童患者的IL-18、IL-10、RANTES和β2-MG水平随病毒载量增加而升高（P < 0.05）。
中国儿童和成人艾滋病患者均存在免疫激活异常，且儿童高于成人。细胞因子水平与艾滋病疾病进展一致，但与总CD4(+) T细胞计数无直接关系。
