肝移植后 HIV 阳性受者的免疫状况。

Immunological profiles of HIV-positive recipients of liver transplant.

机构信息

Infectious Diseases Division, Santa Maria della Misericordia University Hospital, Udine, Italy; Infectious Diseases, Department of Diagnostics and Public Health, University of Verona, Verona, Italy.

Infectious Diseases Division, Santa Maria della Misericordia University Hospital, Udine, Italy; Center of Excellence for Biomedical Research (CEBR), University of Genoa, Italy.

出版信息

Transpl Immunol. 2019 Dec;57:101208. doi: 10.1016/j.trim.2019.05.001. Epub 2019 May 15.

DOI:10.1016/j.trim.2019.05.001

PMID:31102654

Abstract

BACKGROUND

Scarce data are available about immune cell frequencies in HIV-positive recipients of liver transplant. Alterations in immune subsets can lead to persistent immune activation and disease progression or reduced HIV-specific responses. In liver transplantation, impaired immune tolerance can lead to organ rejection.

METHODS

HIV-positive subjects with undetectable HIVRNA and CD4 > 100/mm were included. Control groups were non-transplanted HIV-positive patients with similar immunovirological parameters and healthy subjects. B cells (memory, transitional, and mature subsets), T cells (effector TH1, nonclassic TH1, TH17, TH1/17; T regulatory naïve and effector subsets and CD8 T regulatory cells), and NK cells (CD56 and CD56 subsets) were analyzed by flow cytometry.

RESULTS

A total of 56 patients, including 14 HIV-positive transplant recipients (HIV-LT), 14 HIV-positive controls, and 28 healthy controls were included. Median age of HIV-LT patients was 54.9 years with median time from transplant of 7.6 years. Eleven (79%) were HIV/HCV coinfected. Compared to nontransplanted patients, HIV-LT displayed significantly increased frequency of T CD8 cells, lower percentage of T CD4+ cell, and lower number of nonclassic TH1, TH1/17 cells and naïve T CD4 regulatory cells (Tregs). Healthy controls showed increased numbers of B cell subsets and decreased percentage of T effector subpopulations compared to HIV-LT. Compared to HIV-positive patients, healthy controls had higher B cells, NK cells, CD4 T cells, naïve CD4+ Tregs but lower CD8 T cells, effector Tregs, CD8 Tregs, and all T effector cell subsets.

CONCLUSIONS

Immune cell subpopulations potentially associated with HIV progression and organ rejection were detected in HIV-positive transplant recipients. We confirmed altered frequencies of B, T, and NK cell populations in HIV-positive liver transplant recipients compared to healthy controls. The imbalance among immune cell subsets deserves further studies to identify markers of transplant outcome and potential therapeutic targets.

摘要

背景

关于接受肝移植的 HIV 阳性受者免疫细胞频率的数据很少。免疫亚群的改变可导致持续的免疫激活和疾病进展，或减少 HIV 特异性反应。在肝移植中，免疫耐受受损可导致器官排斥。

方法

纳入 HIVRNA 不可检测且 CD4>100/mm 的 HIV 阳性患者。对照组为具有相似免疫病毒学参数的未接受肝移植的 HIV 阳性患者和健康受试者。通过流式细胞术分析 B 细胞（记忆、过渡和成熟亚群）、T 细胞（效应 TH1、非经典 TH1、TH17、TH1/17；T 调节性幼稚和效应亚群以及 CD8 T 调节细胞）和 NK 细胞（CD56 和 CD56 亚群）。

结果

共纳入 56 例患者，包括 14 例 HIV 阳性肝移植受者（HIV-LT）、14 例 HIV 阳性对照者和 28 例健康对照者。HIV-LT 患者的中位年龄为 54.9 岁，移植后中位时间为 7.6 年。11 例（79%）为 HIV/HCV 合并感染。与未接受肝移植的患者相比，HIV-LT 显示 T CD8 细胞频率显著增加，T CD4+细胞比例降低，非经典 TH1、TH1/17 细胞和幼稚 T CD4 调节细胞（Tregs）数量减少。与 HIV-LT 相比，健康对照组 B 细胞亚群数量增加，效应 T 细胞亚群比例降低。与 HIV 阳性患者相比，健康对照组的 B 细胞、NK 细胞、CD4 T 细胞、幼稚 CD4+Tregs 较多，而 CD8 T 细胞、效应 Tregs、CD8 Tregs 和所有 T 效应细胞亚群较少。