CAJ | 학술논문

目的探讨卡介菌多糖核酸(BCG-PSN)对尖锐湿疣(CA)患者外周血CD4+CD25+Foxp3+调节性T细胞(Treg细胞)的影响.方法 42例首次发病的CA患者分成联合治疗组(26例)和电灼组(16例),联合治疗组给予电灼后肌内注射BCG-PSN 0.35 mg隔日1次连续3个月,电灼组只进行电灼治疗,在初诊时和3个月后分别进行Treg细胞的检测,观察疗效及Treg细胞水平的变化.另有健康体检者30例作为健康对照组.结果 CA患者外周血Treg细胞水平明显高于健康对照组(8.31％±1.24％比5.15％±0.72％,P＜0.01),其中复发组较未复发组高(9.34％±0.72％比7.45％±0.85％,P＜0.01);联合治疗组复发率明显低于电灼组(30.77％比68.75％,P＜0.05),3个月后Treg细胞水平下降,明显低于电灼组(5.87％±1.05％比6.60％±0.75％,P＜ 0.05).结论 Treg细胞比值的高低与CA患者疾病的转归有密切的关系,比值越高越容易复发.BCG-PSN可通过降低Treg细胞的数量来调节CA患者的抗病毒免疫应答,改善其预后.
목적 탐토잡개균다당핵산(BCG-PSN)대첨예습우(CA)환자외주혈CD4+CD25+Foxp3+조절성T세포(Treg세포)적영향.방법 42례수차발병적CA환자분성연합치료조(26례)화전작조(16례),연합치료조급여전작후기내주사BCG-PSN 0.35 mg격일1차련속3개월,전작조지진행전작치료,재초진시화3개월후분별진행Treg세포적검측,관찰료효급Treg세포수평적변화.령유건강체검자30례작위건강대조조.결과 CA환자외주혈Treg세포수평명현고우건강대조조(8.31％±1.24％비5.15％±0.72％,P＜0.01),기중복발조교미복발조고(9.34％±0.72％비7.45％±0.85％,P＜0.01);연합치료조복발솔명현저우전작조(30.77％비68.75％,P＜0.05),3개월후Treg세포수평하강,명현저우전작조(5.87％±1.05％비6.60％±0.75％,P＜ 0.05).결론 Treg세포비치적고저여CA환자질병적전귀유밀절적관계,비치월고월용역복발.BCG-PSN가통과강저Treg세포적수량래조절CA환자적항병독면역응답,개선기예후.
Objective To evaluate the effect of polysaccharide nucleic acid fraction of bacillus Calmette-Guerin (BCG-PSN) on peripheral blood CD4+CD25+Foxp3+ regulatory T (Treg) cells in patients with condyloma acuminatum (CA).Methods Forty-two patients with first onset of CA were randomly assigned to receive either injection of BCG-PSN (0.35 mg every other day for 3 months) after fulguration (combination group,26 patients),or fulguration only (fulguration group,16 patients).Venous blood samples were obtained from all the patients at the initial visit and three months after the beginning of treatment,as well as from 30 healthy checkup examinees.The percentage of peripheral Treg cells in CD4+ T lymphocytes was determined by flow cytometry.The recurrence of CA was evaluated during the three months after the beginning of treatment.Results The percentage of peripheral Treg cells in CD4+ T lymphocytes was significantly higher in patients with CA than in the controls (8.31％ ± 1.24％ vs.5.15％ ± 0.72％,P ＜ 0.01),and in patients with clinical recurrence of CA than in those without (9.34％ ± 0.72％ vs.7.45％ ± 0.85％,P ＜ 0.01).The recurrence rate was significantly lower in the combination group than in the fulguration group (30.77％ vs.68.75％,P ＜ 0.05).After three months of treatment,the combination group showed lower percentage of Treg cells in CD4+ T cells compared with the fulguration group (5.87％ ± 1.05％ vs.6.60％ ± 0.75％,P ＜ 0.05).Conclusions The percentage of Treg cells has a close relationship with the progression of CA,i.e.,the higher the percentage,the more frequent the relapse.BCG-PSN may enhance the antiviral immune response in patients with CA and improve their prognosis by reducing the number of Treg cells.