CAJ | 학술논문

目的：探讨局部44℃温热治疗尖锐湿疣的效果及对外周血CD4+CD25+Foxp3+调节性T细胞(CD4+CD25+Foxp3+Treg细胞)及相关因子的影响,以研究其在尖锐湿疣发病机制中的作用。方法选取2013年1月~2015年4月℃阳市中心医院皮肤科门诊就诊的尖锐湿疣患者35例(CA组),正常者35例作为对照组,CA组应用局部44℃温热治疗,3个月后评价疗效并测定治疗前后外周血血清中CD4+CD25+Foxp3+Treg细胞和相关因子水平,并与对照组进行比较分析。结果 CA组患者外周血CD4+CD25+Treg细胞、CD4+CD25+Foxp3+Treg细胞百分比及CD4+CD25+T细胞表面抑制性膜分子CTLA-4、GITR、PD-L表达均明显高于对照组(t=9.52、15.07、8.63、9.16、10.92,均P<0.05)；胞内IL-10和TGF-β阳性细胞百分比较对照组增多(t=3.22,7.02,均P<0.05)；CA组治疗3个月,总有效率为85.71%(30/35),治疗中未见明显副作用。外周血CD4+CD25+Treg细胞、CD4+CD25+Foxp3+Treg细胞百分比、CTLA-4、GITR、PD-L水平及IL-10、TGF-β阳性细胞百分比均较治疗前显著降低,差异均有统计学意义(t =7.76、12.91、7.46、7.68、9.29、2.64、6.01,均P<0.05)。结论 HPV感染可活化增殖CD4+CD25+Foxp3+Treg细胞,其高表达协同刺激分子和抑制性细胞因子,温热治疗尖锐湿疣安全有效,其治疗机制可能与调节CD4+CD25+Foxp3+Treg细胞及相关因子有关。
목적：탐토국부44℃온열치료첨예습우적효과급대외주혈CD4+CD25+Foxp3+조절성T세포(CD4+CD25+Foxp3+Treg세포)급상관인자적영향,이연구기재첨예습우발병궤제중적작용。방법선취2013년1월~2015년4월℃양시중심의원피부과문진취진적첨예습우환자35례(CA조),정상자35례작위대조조,CA조응용국부44℃온열치료,3개월후평개료효병측정치료전후외주혈혈청중CD4+CD25+Foxp3+Treg세포화상관인자수평,병여대조조진행비교분석。결과 CA조환자외주혈CD4+CD25+Treg세포、CD4+CD25+Foxp3+Treg세포백분비급CD4+CD25+T세포표면억제성막분자CTLA-4、GITR、PD-L표체균명현고우대조조(t=9.52、15.07、8.63、9.16、10.92,균P<0.05)；포내IL-10화TGF-β양성세포백분비교대조조증다(t=3.22,7.02,균P<0.05)；CA조치료3개월,총유효솔위85.71%(30/35),치료중미견명현부작용。외주혈CD4+CD25+Treg세포、CD4+CD25+Foxp3+Treg세포백분비、CTLA-4、GITR、PD-L수평급IL-10、TGF-β양성세포백분비균교치료전현저강저,차이균유통계학의의(t =7.76、12.91、7.46、7.68、9.29、2.64、6.01,균P<0.05)。결론 HPV감염가활화증식CD4+CD25+Foxp3+Treg세포,기고표체협동자격분자화억제성세포인자,온열치료첨예습우안전유효,기치료궤제가능여조절CD4+CD25+Foxp3+Treg세포급상관인자유관。
Objective To investigate the curative effects of local hyperthermia at 44℃ on peripheral blood of CD4+CD25+Foxp3+regulatory T cells and correlation factors in condyloma acuminatum (CA), so as to investigate the patho-genesy of CA. Methods From January 2013 to April 2015, 35 patients with condyloma acuminatum in Yiyang Central Hospital were selected, and 35 normal cases were selected as control group. The CA group were given local hyperther-mia at 44℃ therapy, and the concentrations of CD4+CD25+Foxp3+ regulatory T cells and correlation factor in serum were detected before and after treatment, then the therapeutic effect after 3 months was assessed. And comparative analysis with the control group was proceeded. Results The number of CD4+CD25+Tregs, CD4+CD25+Foxp3+Tregs and the expressions of CTLA-4, GITR and PD-L were increased significantly in peripheral blood of patients in CA group, and higher than those of the control group (t =9.52, 15.07, 8.63, 9.16, 10.92, all P<0.05). The numbers of IL-10 and TGF-β in CD4+CD25+ T cells were significantly increased in peripheral blood of patients compared with those from control group(t =3.22, 7.02,P<0.05). The percent of positive cell of CD4+CD25+Tregs, CD4+CD25+Foxp3+Tregs and the expressions levels of CTLA-4, GITR, PD-L, and percent of positive cell of IL-10 and TGF-β of the CA group after treatment were lower than those before treatment (t =7.76, 12.91, 7.46, 7.68, 9.29, 2.64, 6.01, all P< 0.05). Conclu-sion HPV infection can result in the activation and proliferation of CD4+CD25+Tregs, its expression of high levels al-lostimulatory molecules and suppressive cytokines. Local themotherapy at 44℃is a safe and effective single modality in the treatment of CA, the mechanism may be through the regulation of the expressions of CD4+CD25+Foxp3+regulatory T cells and correlation factors.