在ANCA相关的血管炎和与动脉硬相关的CD4+CD28- T细胞扩张:随机对照试验的基线数据
Dimitrios Chanouzas1, Lovesh Dyall1, Jessica Dale1
1School of Immunity and Infection, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
Lancet (London, England)
|August 28, 2015
概括
抗中性细胞质抗体相关性血管炎 (AAV) 患者患有细胞巨核病毒 (CMV) 的心血管风险增加. CD4+CD28- T细胞与动脉硬有关,而瓦拉西克洛维尔治疗减少了这些细胞.
科学领域:
- 免疫学
- 心血管医学
- 病毒学
背景情况:
- 抗中性粒细胞体抗体 (ANCA) 相关的血管蛋白 (AAV) 会增加心血管疾病的风险.
- CD4+CD28- T细胞在细胞大脑病毒 (CMV) 阳性AAV患者中扩大,与死亡率和动脉硬相关.
研究的目的:
- 评估CMV阳性AAV患者中CD4+CD28- T细胞与动脉硬之间的关联.
- 要确定瓦拉西克洛维尔治疗是否减少CD4+CD28- T细胞群.
主要方法:
- 在一项开放的第二阶段试验中,28名AAV患者随机接受了瓦拉西克洛维尔或没有额外的治疗6个月.
- 测量了动脉硬度;通过流细胞测量分析了CD4+CD28- T细胞和IFNγ分泌.
- 评估了CD4+CD28- T细胞和PWV之间的相关性;进行了治疗意向分析.
主要成果:
- 与CD4+CD28+T细胞相比,CD4+CD28- T细胞的T- bet表达和IFNγ分泌量更高.
- 内皮功能障碍的标志物CX3CR1仅在CD4+CD28- T细胞上表达.
- CD4+CD28- T细胞与PWV相关的比例 (r=0. 408, p=0. 035);瓦拉西克洛维尔治疗显著降低了这些细胞.
结论:
- 在AAV中CD4+CD28- T细胞是促炎的,表达CX3CR1,并与动脉硬相关.
- 瓦拉西克洛维尔治疗减弱了CD4+CD28- T细胞的扩张.
- 鉴于心血管疾病在AAV死亡率中的作用,这一发现具有意义.
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