基于IL-7/IL-7R通路和Th17/Treg平衡探究广西两个中药制剂治疗艾滋病免疫重建不良的机制

Suboptimal immunologic response is a difficult problem on treating AIDS, partly caused by T cell homeostasis regulated by IL-7/IL-7R pathway and Th17/Treg immune balance.Early studies have shown that two Chinese native medicine preparation in guangxi(shenlingfuzheng capsule, qingdu capsules) can promote the immune reconstruction.Supporting by the national Chinese medicine pilot project to treat AIDS and national free HIV treatment clinic,this project enroll 50 cases deficiency of spleen qi and insufficiency of the spleen with overabundance of dampness AIDS suboptimal immunologic response respectively treated with HAART and chinese herbs for 12 months,compare with 50 HAART only, testing with FCM (flow cytometry method),ELISA (enzyme linked immuno sorbent assay),RT-PCR (reverse transcription polymerase chain reaction),detects IL-7、CD127(IL-7R)、CD4+CD25+Fox P3+、CD4+IL-17A+、IL-2、IL-15, CD4、 CD8 cell count、HIV virus load at 0,6,12 month,analysizing the changes and relationship among these indexes and effect on the progress disease of AIDS, explores the mechanism of Chinese medicine preparation on AIDS from T cell homeostasis regulated by IL-7/IL-7R pathway and Th17/Treg immune balance,provides foundation of evaluation of therapeutic effect and drug development on AIDS treating with Chinese medicine.

免疫重建不良是艾滋病治疗的难点问题，IL-7/IL-7R通路和Th17/Treg平衡调节的T细胞稳态失衡是免疫重建不良的重要机制，前期研究显示广西两个中药院内制剂（参灵扶正胶囊、清毒胶囊）可促进免疫重建。本项目依托国家中医药治疗艾滋病项目和免费抗 HIV 治疗点，收集使用两个制剂（脾气虚、脾虚湿盛）和单用HAART的艾滋病免疫重建不良患者各50例的血样，采用流式细胞术、ELISA、RT-PCR等方法，检测服药0、6、12个月IL-7、CD127(IL-7R)、CD4+CD25+Fox P3+、CD4+IL-17A+、IL-2、IL-15 、CD4+、CD8+T细胞计数、HIV载量等指标，分析其变化，从IL-7/IL-7R通路和Th17/Treg细胞免疫平衡探究中医药治疗艾滋病免疫重建不良的T细胞稳态调控机制，为阐明中医药治疗艾滋病免疫重建不良的疗效机制和药物研发提供参考。

本项目依托国家中医药治疗艾滋病项目和免费抗 HIV 治疗点，收集使用两个制剂（脾气虚、脾虚湿盛）联合HAART（简称中西药1组、中西药2组）和单用HAART（简称西药组）的艾滋病免疫重建不良患者血样，采用流式细胞术、ELISA、RT-PCR等方法，检测服药0、12个月IL-7、CD127(IL-7R)、CD4+CD25+FoxP3+、CD4+IL-17A+、IL-2、IL-15 、CD4+、CD8+T细胞计数、HIV载量等指标，分析其变化，从IL-7/IL-7R通路和Th17/Treg细胞免疫平衡探究中医药治疗艾滋病免疫重建不良的T细胞稳态调控机制，结果显示治疗后各组CD4细胞计数均增加中西药组优于单用西药组，各组治疗后的HIV载量均低于检测水平（HIVVL＜20拷贝/ml），没有差异；组内比较治疗前后各组的IL-7治疗后下降，IL-2、IL-15、CD127、IL-17A均上升，治疗后组间比较IL-2、IL-15、IL-17A没有差异（P＞0.05），CD127中西药1组与中西药2组和西药组间有显著性差异，CD4+CD25+FoxP3+治疗前后组内、组间比较没有差异，提示中西药合用和单用HAART对免疫重建不良患者均有促进免疫重建作用，其机制与调节IL-7/IL-7R通路和Th17/Treg细胞免疫失衡有关。本项目为中医药治疗艾滋病免疫重建功能不良的机制研究、疗效评价提供参考。