ﻲﺸﻫوﮋﭘ ﻪﻟﺎﻘﻣ * لﻮﺌﺴﻣ هﺪﻨﺴﻳﻮﻧ : ،ﻲﻟﻮﻜﻟﻮﻣ ،ﻲﻟﻮﻠﺳ تﺎﻘﻴﻘﺤﺗ ﺰﻛﺮﻣ ،ﻪﻴﺘﻤﺣر ،دﺮﻛﺮﻬﺷ ﻦﻔﻠﺗ : 3336720 -0381 ، E-mail:bat238@yahoo.com
يﺎﻫ ﺖﻴﺳﻮﻔﻨﻟ يﺎﻫ هوﺮﮔ ﺮﻳز ﻲﻧاواﺮﻓ
T
ﻞﻣاﻮﻋ و روژﺎﻣ ﻲﻤﺳﻻﺎﺗ ﻪﺑ ﻼﺘﺒﻣ نارﺎﻤﻴﺑ رد
نآ ﺮﺑ ﺮﺛﻮﻣ
ﻲﻤﻳﺮﻛ ﻼﻴﻟ
1رﺎﻜﺸﺑ نﺎﻣﮋﭘ ،
1دازﺮﻴﺷ ﻪﻟا ﺖﻳاﺪﻫ ﺮﺘﻛد ،
1يﺮﻴﺧ نﺎﻤﻴﻠﺳ ﺮﺘﻛد ،
2ﻲﺘﺳار ﻢﻳﺮﻣ ،
3،
ﺪﻴﺳ ﺮﺘﻛد
ﺪﻤﺤﻣ
ﺶﺨﺑرﻮﻧ ﻢﻇﺎﻛ
3يﺮﺼﻴﻗرﻮﭘ لﻮﺘﺑ ﺮﺘﻛد ،
4 * 1 ،ﻲﻟﻮﻜﻟﻮﻣ ،ﻲﻟﻮﻠﺳ تﺎﻘﻴﻘﺤﺗ ﺰﻛﺮﻣ ﮕﺸﻧاد ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎ دﺮﻛﺮﻬﺷ ،دﺮﻛﺮﻬﺷ ، ؛ناﺮﻳا 2 ،دﺮﻛﺮﻬﺷ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ،ﻲﺘﺴﻳز رﺎﻣآ هوﺮﮔ ؛ناﺮﻳا ،دﺮﻛﺮﻬﺷ 3 لﺎﻔﻃا هوﺮﮔ ، ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ،دﺮﻛﺮﻬﺷ ،دﺮﻛﺮﻬﺷ ناﺮﻳا ؛ 4 تﺎﻘﻴﻘﺤﺗ ﺰﻛﺮﻣ ﻲﻳوراد نﺎﻫﺎﻴﮔ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ، ،دﺮﻛﺮﻬﺷ ناﺮﻳا ،دﺮﻛﺮﻬﺷ ﺖﻓﺎﻳرد ﺦﻳرﺎﺗ : 28 / 9 / 91 ﻳﺎﻬﻧ حﻼﺻا ﻲ : 16 / 11 / 91 شﺮﻳﺬﭘ ﺦﻳرﺎﺗ : 22 / 11 / 91 ﻪﻣﺪﻘﻣ : ﻲﻜﻴﺘﻧژ تﻻﻼﺘﺧا زا نﻮﮕﻤﻫﺎﻧ ﻲﻫوﺮﮔ ﻲﻤﺳﻻﺎﺗ يﺎﻫ هﺮﻴﺠﻧز زا ﻲﻜﻳ ﺖﺧﺎﺳ ﺖﻋﺮﺳ ﺶﻫﺎﻛ ﺮﺛا رد ﻪﻛ ﺖﺳا ﻦﻴﺑﻮﻠﮔﻮﻤﻫ هﺮﻴﺠﻧز ﺐﻠﻏا و α ﺎﻳ β ﺪﻳآ ﻲﻣ دﻮﺟو ﻪﺑ . رد ﻧاﺮﺘﻳﺪﻣ ﻲﻟاﻮﺣ يﺎﻫرﻮﺸﻛ ﻪ عﻮﻴﺷ ﻪﻧﺎﻴﻣروﺎﺧ و β ﻻﺎﺗ ﻲﻤﺳ روژﺎﻣ بﻮﻴﻌﻣ نژ ود نﺎﻣﺰﻤﻫ ثراﻮﺗ ﺖﻠﻋ ﻪﺑ β ﻲﻤﺳﻻﺎﺗ ﺪﺷﺎﺑ ﻲﻣ ) 1 ( . ﻲﻧژ ﺶﻬﺟ ﻪﺑ نﺎﻳﻼﺘﺒﻣ ﺖﻴﻌﻤﺟ رد ﺐﻟﺎﻏ ﺎﺘﺑ ﻲﻧاﺮﻳا ﻲﻤﺳﻻﺎﺗ IVSII-I(G→A) ناﺰﻴﻣ ﻪﻛ ﺖﺳا ﻲﻣ ﺮﺘﺸﻴﺑ ﻲﻟﺎﻤﺷ ﻖﻃﺎﻨﻣ رد نآ ﻲﻧاواﺮﻓ ﺪﺷﺎﺑ . ﻲﻧژ ﺶﻬﺟ هﺪﻴﻜﭼ : فﺪﻫ و ﻪﻨﻴﻣز : ﻦﻫآ ﻊﻓد نﺎﻣرد و رﺮﻜﻣ يﺎﻫ نﻮﺧ ﻖﻳرﺰﺗ ﻲﻤﺳﻻﺎﺗ نارﺎﻤﻴﺑ رد ﻲﻧﺎﻣرد ﺞﻳار يﺎﻫرﺎﻜﻫار زا ﺖﺳا . ﻻﺎﺗ نارﺎﻤﻴﺑ رد يﺪﺟ تﻼﻜﺸﻣ زا ﻲﻧﻮﻔﻋ ضراﻮﻋ زا ﻲﺷﺎﻧ ﺪﻧاﻮﺗ ﻲﻣ ﻪﻛ ﺪﻳآ ﻲﻣ بﺎﺴﺣ ﻪﺑ ﻲﻤﺳ ﺪﺷﺎﺑ ﻲﻜﻳژﻮﻟﻮﻧﻮﻴﻤﻳا يﺎﻫ يرﺎﺠﻨﻫﺎﻧ . يﺎﻫ ﺖﻴﺳﻮﻔﻨﻟ ﻲﻠﺻا يﺎﻫ هوﺮﮔ ﺮﻳز ﻲﻧاواﺮﻓ ﺮﺿﺎﺣ ﻪﻌﻟﺎﻄﻣ رد T طﺎﺒﺗرا و ﺖﺳا ﻪﺘﻓﺮﮔ راﺮﻗ ﻲﺳرﺮﺑ درﻮﻣ ﻦﻫآ ﻊﻓد نﺎﻣرد و مﺮﺳ ﻦﻴﺘﻳﺮﻓ ،نﻮﺧ ﻖﻳرﺰﺗ ناﺰﻴﻣ ،ﻦﺳ ﺎﺑ ﺎﻫ نآ . ﻲﺳرﺮﺑ شور : ﻲﻔﻴﺻﻮﺗ ﻪﻌﻟﺎﻄﻣ ﻦﻳا رد -ﻘﻣ ﻲﻌﻄ 27 نﺎﺘﺳرﺎﻤﻴﺑ ﻪﺑ هﺪﻨﻨﻛ ﻪﻌﺟاﺮﻣ روژﺎﻣ ﻲﻤﺳﻻﺎﺗ ﻪﺑ ﻼﺘﺒﻣ رﺎﻤﻴﺑ دﺮﻛﺮﻬﺷ ﺮﺟﺎﻫ لﺎﺳ رد 1390 ﻲﻨﺳ هدوﺪﺤﻣ ﺎﺑ 30 -10 ﻲﻫﺎﮕﺸﻳﺎﻣزآ و ﻲﻨﻴﻟﺎﺑ يﺎﻫرﺎﻴﻌﻣ سﺎﺳا ﺮﺑ ﻪﻛ لﺎﺳ ﺪﻧدﺮﻛ ﺖﻛﺮﺷ ،ﺪﻧدﻮﺑ هﺪﺷ هداد ﺺﻴﺨﺸﺗ . هوﺮﮔ ﻚﻳ ﻞﻣﺎﺷ ﺰﻴﻧ ﺪﻫﺎﺷ هوﺮﮔ 26 زا ﻪﻛ ﺪﻧدﻮﺑ ﻢﻟﺎﺳ داﺮﻓا زا هﺮﻔﻧ ﺟ و ﻦﺳ ظﺎﺤﻟ ﺪﻨﺘﺷاد ﺖﻘﺑﺎﻄﻣ نارﺎﻤﻴﺑ ﺎﺑ ﺲﻨ . يروآ ﻊﻤﺟ ﻦﻳرﺎﭙﻫ ﻢﻳﺪﺳ يوﺎﺣ يﺎﻫ ﻪﻟﻮﻟ رد يﺪﻳرو نﻮﺧ ﻪﻧﻮﻤﻧ ﺰﻴﻟﺎﻧآ درﻮﻣ و ﺪﻳدﺮﮔ يﺰﻴﻣآ ﮓﻧر ﺖﻨﺳرﻮﻠﻓ راﺪﻧﺎﺸﻧ لﺎﻧﻮﻠﻛﻮﻨﻣ يﺎﻫ يدﺎﺑ ﻲﺘﻧآ ﺎﺑ ﺰﻣﺮﻗ يﺎﻫ لﻮﺒﻠﮔ ﺰﻴﻟ زا ﺲﭘ و ﺖﻓﺮﮔ راﺮﻗ ﻚﻳﺮﺘﻣﻮﺘﻳﺎﺳﻮﻠﻓ . رﺎﻤﺷ و قﻮﻓ ﺰﻴﻟﺎﻧآ ﺞﻳﺎﺘﻧ ﻪﺑ ﻪﺟﻮﺗ ﺎﺑ ﺎﻫ لﻮﻠﺳ داﺪﻌﺗ ﺪﻳدﺮﮔ ﻪﺒﺳﺎﺤﻣ ﻲﻧﻮﺧ ش . ﺞﻳﺎﺘﻧ راﺰﻓا مﺮﻧ رد SPSS يﺎﻫ نﻮﻣزآ زا هدﺎﻔﺘﺳا ﺎﺑ و Mann-Withney ﺪﻧﺪﺷ ﻞﻴﻠﺤﺗ و ﻪﻳﺰﺠﺗ ﻦﻣﺮﻴﭙﺳا ﻲﮕﺘﺴﺒﻤﻫ و . ﻪﺘﻓﺎﻳ ﺎﻫ : يﺎﻫ ﺖﻴﺳﻮﻔﻨﻟ ﺪﺻرد و ﺪﻫﺎﺷ هوﺮﮔ زا ﺶﻴﺑ يراد ﻲﻨﻌﻣ ترﻮﺻ ﻪﺑ نارﺎﻤﻴﺑ رد ﺎﻫ ﺖﻴﺳﻮﻔﻨﻟ ﻖﻠﻄﻣ داﺪﻌﺗ T ﻪﺑ ﺪﻫﺎﺷ هوﺮﮔ زا ﺮﺘﻤﻛ يراد ﻲﻨﻌﻣ ترﻮﺻ دﻮﺑ ) 001 / 0 < P .( ﺖﻴﺳﻮﻔﻨﻟ داﺪﻌﺗ يﺎﻫ T هوﺮﮔ ود ﺮﻫ رد CD4 و CD8 ﺖﺷاﺪﻧ يراد ﻲﻨﻌﻣ توﺎﻔﺗ ﺪﻫﺎﺷ هوﺮﮔ و نارﺎﻤﻴﺑ ﻦﻴﺑ ) 05 / 0 > P .( ﺖﻴﺳﻮﻔﻨﻟ ﻲﻧاواﺮﻓ يﺎﻫ CD3+CD27+ ودﺮﻫ رد لﻮﻠﺳ عﻮﻧ CD4 و CD8 دﻮﺑ لﺮﺘﻨﻛ هوﺮﮔ زا ﺮﺘﻤﻛ نارﺎﻤﻴﺑ رد هوﺮﮔ ﺮﻳز رد ﺎﻬﻨﺗ توﺎﻔﺗ ﻦﻳا ﻪﻛ CD4 ﻲﺋﺰﺟ رﻮﻃ ﻪﺑ ﻨﻌﻣ ﻲ دﻮﺑ راد ) 07 / 0 = P .( ﺖﻴﺳﻮﻔﻨﻟ داﺪﻌﺗ يﺎﻫ CD3+CD4+CD27+ داﺪﻌﺗ و لاﺮﻔﺳد فﺮﺼﻣ و نﻮﺧ ﻖﻳرﺰﺗ ناﺰﻴﻣ ﺎﺑ ﺖﻴﺳﻮﻔﻨﻟ يﺎﻫ CD3+CD8+CD27+ فﺮﺼﻣ و نﻮﺧ ﻖﻳرﺰﺗ ،ﻦﺳ ﺎﺑ ﺖﺷاد سﻮﻜﻌﻣ ﻲﮕﺘﺴﺒﻤﻫ لاﺮﻔﺳد . يﺮﻴﮔ ﻪﺠﻴﺘﻧ : ﺮﺑ ﻪﻛ روژﺎﻣ ﻲﻤﺳﻻﺎﺗ ﻪﺑ ﻼﺘﺒﻣ نارﺎﻤﻴﺑ ﻪﻛ ﺖﻔﮔ ناﻮﺗ ﻲﻣ ﻪﻌﻟﺎﻄﻣ ﻦﻳا ﺞﻳﺎﺘﻧ سﺎﺳا ﺖﻴﺗﺎﭙﻫ ﺮﻈﻧ زا B و C لﻮﻠﺳ ﻒﻴﻔﺧ تﻻﻼﺘﺧا ﺪﻨﺘﺴﻫ ﻲﻔﻨﻣ T ﺪﻧراد . ﻲﺘﻴﺳﻮﻔﻨﻟ هوﺮﮔ ﺮﻳز ﻂﺳﻮﺘﻣ ﺶﻳاﺰﻓا CD3+CD27 ًﻻﺎﻤﺘﺣا ﺎﺑ ﺪﻧاﻮﺗ ﻲﻣ هﺪﻳﺪﭘ ﻦﻳا و ﺖﺳا ﻲﺻﺎﺼﺘﺧا ﺮﻴﻏ ﻚﻴﻧژ ﻲﺘﻧآ ﻚﻳﺮﺤﺗ هﺪﻨﻨﻛ ﺲﻜﻌﻨﻣ طﺎﺒﺗرا ناﺰﻴﻣ ،ﻦﺳ ﻦﻴﺑ ﻲﻔﻨﻣ لﻮﻠﺳ ﻲﻧاواﺮﻓ ﺎﺑ ﻦﻫآ ﻊﻓد نﺎﻣرد و نﻮﺧ ﻖﻳرﺰﺗ يﺎﻫ CD3+ CD27+ دﻮﺷ هداد ﺢﻴﺿﻮﺗ . او ژ يﺪﻴﻠﻛ يﺎﻫ ه : ﺖﻴﺳﻮﻔﻨﻟ T ، روژﺎﻣ ﻲﻤﺳﻻﺎﺗ ، ﺖﻴﺳﻮﻔﻨﻟ ،ﻲﻨﻤﻳا يﺮﻴﭘ CD27 -.IVSI-V(G→C) ﺑ ﻪ ﻲﺑﻮﻨﺟ ﻲﺣاﻮﻧ رد ﻊﻳﺎﺷ ترﻮﺻ دﻮﺷ ﻲﻣ هﺪﻫﺎﺸﻣ ناﺮﻳا ) 2 ( . عﻮﻴﺷ ناﺰﻴﻣ β رد ﻲﻤﺳﻻﺎﺗ ،نﺎﻬﻔﺻا ﻲﻗﺮﺷ بﻮﻨﺟ ﻲﺣاﻮﻧ و سرﺎﻓ 10 -8 ﺪﺻرد ﺖﺳا هﺪﺷ دروآﺮﺑ ) 3 (. يرﺎﻤﻴﺑ ﻦﻳا رد ﺞﻳار ﻲﻧﺎﻣرد يﺎﻫرﺎﻜﻫار زا و دﺪﻌﺘﻣ ﻖﻳرﺰﺗ نﺎﻣرد نآ لﺎﺒﻧﺪﺑ ﻪﻛ ﺖﺳا ﻲﻧﻮﺧ ﻢﻈﻨﻣ ﻦﻫآ رﺎﺑ ﻪﻓﺎﺿا زا ﻲﺷﺎﻧ ضراﻮﻋ لﺮﺘﻨﻛ ﺖﻬﺟ ﻦﻫآ ﻊﻓد ﻲﻣ ﻪﻴﺻﻮﺗ ددﺮﮔ ) 1 ( . ﻲﻣﻮﺘﻜﻨﻠﭙﺳا ) Splenectomy ( ، ﻪﺑ زﺎﻴﻧ ﺶﻫﺎﻛ ﺖﻬﺟ ﻪﻛ ﺖﺳا ﻲﻧﺎﻣرد يﺪﻌﺑ بﺎﺨﺘﻧا و نﻮﺧ دﻮﺷ ﻲﻣ دﺎﻬﻨﺸﻴﭘ ﻦﻴﺑﻮﻠﮔﻮﻤﻫ ﻆﻔﺣ ) 4 .( ﻦﻳا ﺎﺑ نﺎﻣرد ضراﻮﻋ دﻮﺟو ، ﺖﺤﺗ ار داﺮﻓا ﻲﮔﺪﻧز ﺖﻴﻔﻴﻛ ﺗﺄ ﻲﻣ راﺮﻗ ﺮﻴﺛ ﺪﻫد ) 3 (. ﻦﻳﺮﺗ ﻲﻠﺻا زا ﻲﻧﻮﻔﻋ ضراﻮﻋ يرﺎﻤﻴﺑ ﻞﻣاﻮﻋ و گﺮﻣ ﻞﻣﺎﻋ ﻦﻴﻣود و از نارﺎﻤﻴﺑ رد ﺮﻴﻣ ﺎﺘﺑ ﻪﺑ ﻼﺘﺒﻣ ﻻﺎﺗ ﺎﻣ ﻲﻤﺳ روﮋ ﻳآ ﻲﻣ بﺎﺴﺣ ﻪﺑ ﻨ رﻮﺼﺗ ﻪﻛ ﺪ ﺪﻨﺷﺎﺑ ﻲﻜﻳژﻮﻟﻮﻧﻮﻴﻤﻳا يﺎﻫ يرﺎﺠﻨﻫﺎﻧ زا ﻲﺷﺎﻧ دﻮﺷ ﻲﻣ ) 4 ( . ﺖﻬﺟ يدﺎﻳز يﺎﻫ ﻲﺳرﺮﺑ ﺮﻴﺧا يﺎﻫ لﺎﺳ رد ﻞﻴﻟد ﻦﻴﻤﻫ ﻪﺑ نارﺎﻤﻴﺑ ﻦﻳا رد لارﻮﻤﻫ و ﻲﻟﻮﻠﺳ ﻲﻨﻤﻳا تﻻﻼﺘﺧا ﻪﻌﻟﺎﻄﻣ يﺎﻫ يرﺎﺠﻨﻫﺎﻧ زا ﻲﻌﻴﺳو ﻒﻴﻃ و ﺖﺳا ﻪﺘﻓﺮﮔ ترﻮﺻ ﺪﺷ شراﺰﮔ ﺎﻫ نآ رد ﻲﻨﻤﻳا ﺖﺳا ه ) 7 -5 .( و ﻲﻧژ ﻲﺘﻧآ مواﺪﻣ ﻚﻳﺮﺤﺗ سوﺮﻳو لﺎﻘﺘﻧا ﺎﺑ ﺎﻫ ﺮﻴﻈﻧ ﻲﻨﻤﻳا يﺮﮕﺑﻮﻛﺮﺳ تﺎﻴﺻﻮﺼﺧ HCV ، HBV و CMV نﻮﺧ ﻖﻳرﺰﺗ ﻲﻃ ﻊﻳﺮﺴﺗ ﻪﺑ ﺮﺠﻨﻣ رﺮﻜﻣ يﺎﻫ ﻲﻣ ﻲﻨﻤﻳا يﺮﻴﭘ ﺪﻨﻳآﺮﻓ ددﺮﮔ ) 10 -8 ( . دﻮﺟو ﻂﻳاﺮﺷ يﺮﻴﭘ ﺖﻓﺮﺸﻴﭘ ﺖﻬﺟ هﺪﻤﻋ يﺎﻫرﻮﺘﻛﺎﻓ زا ﻪﻛ ﻮﻴﺗاﺪﻴﺴﻛا ،ﺖﺳا ﻲﻨﻤﻳا ﺎﺘﺑ ﻪﺑ نﺎﻳﻼﺘﺒﻣ رد ﺎﻣ ﻲﻤﺳﻻﺎﺗ ﻞﻴﻟد ﻪﺑ روﮋ دﻮﺷ ﻲﻣ هﺪﻳد ﺰﻴﻟﻮﻤﻫ و مواﺪﻣ يﺎﻫ نﻮﺧ ﻖﻳرﺰﺗ ) 13 -11 ( . رد ﻲﻨﻤﻳا ﻢﺘﺴﻴﺳ ندﺮﻛ ناﻮﺗﺎﻧ ﺮﺑ هوﻼﻋ ﻲﻣﻮﺘﻜﻨﻠﭙﺳا ﻲﻓﺮﻃ زا يﺎﻫ يﺮﺘﻛﺎﺑ ﺮﺑاﺮﺑ رد ﺖﻇﺎﻔﺣ ﺪﻳﺪﺸﺗ ﻪﺑ ﺮﺠﻨﻣ راﺪﻟﻮﺴﭙﻛ ﻲﻨﻤﻳا ﻢﺘﺴﻴﺳ ﺮﺑ مواﺪﻣ نﻮﺧ ﻖﻳرﺰﺗ زا ﻲﺷﺎﻧ ضراﻮﻋ ددﺮﮔ ﻲﻣ ) 3 (. ﺣ ﻪﻌﻟﺎﻄﻣ رد ﺎ ﺿ ﮔ ﺮﻳز ﺮ هوﺮ ﺖﻴﺳﻮﻔﻨﻟ يﺎﻫ ﺎﺑ ﺎﻫ يﺮﺘﻣﻮﺘﻳﺎﺳﻮﻠﻓ زا هدﺎﻔﺘﺳا 4 يﺮﻴﭘ و ﻲﺳرﺮﺑ درﻮﻣ ﻪﻟﺎﻧﺎﻛ تاﺮﻴﻴﻐﺗ هﺎﮔﺪﻳد زا ﻲﻨﻤﻳا CD4/CD8 نﺎﻴﺑ و CD27 ﺖﺳا ﻪﺘﻓﺮﮔ راﺮﻗ ﻪﺟﻮﺗ درﻮﻣ . يﺎﻫ لﻮﻜﻟﻮﻣ CD27 ﺲﭘ لﻮﻠﺳ ﺢﻄﺳ رد ﻚﻴﻧژ ﻲﺘﻧآ ﻚﻳﺮﺤﺗ زا ﺶﻫﺎﻛ ﺎﻫ ﺑﺎﻳ ﻲﻣ ﻨ ﺪ ) 14 ( ﻲﻨﻤﻳا يﺮﻴﭘ زا يا ﻪﻧﺎﺸﻧ و ﻫ ﺘﺴ ﺪﻨ . ﻪﺟﻮﺗ ﺎﺑ رﺮﻜﻣ نﻮﺧ ﻖﻳرﺰﺗ ﺎﺑ روژﺎﻣ ﻲﻤﺳﻻﺎﺗ ﻪﺑ ﻼﺘﺒﻣ نارﺎﻤﻴﺑ ﻪﻜﻨﻳا ﻪﺑ ﺪﻨﺘﺴﻫ توﺎﻔﺘﻣ يﺎﻫ نژ ﻲﺘﻧآ ﺎﺑ مواﺪﻣ درﻮﺧﺮﺑ ضﺮﻌﻣ رد ، رد ﺰﻴﻧ ﺎﻫ ﺖﻴﺳﻮﻔﻨﻟ زا هوﺮﮔ ﺮﻳز ﻦﻳا ﻲﺳرﺮﺑ ور ﻦﻳا زا آ ﺎﺑ ﺎﻬﻧ ﺖﻴﻤﻫا ﺪﺳر ﻲﻣ ﺮﻈﻧ ﻪﺑ . ﺗ ﻦﻳا ﺮﺑ هوﻼﻋ ﺄ ﺮﻴﻈﻧ ﻲﻠﻣاﻮﻋ ﺮﻴﺛ ﺮﺑ نﻮﺧ ﻖﻳرﺰﺗ ناﺰﻴﻣ و ﻦﻴﺘﻳﺮﻓ ناﺰﻴﻣ ،ﻦﺳ ﻦﻳا ﺮﻴﻴﻐﺗ ﺖﺳا ﻪﺘﻓﺮﮔ راﺮﻗ ﻲﺳرﺮﺑ درﻮﻣ ﭗﻴﺗﻮﻨﻓ . ﻲﺳرﺮﺑ شور : ﻪﻌﻟﺎﻄﻣ ﻦﻳا ﻲﻔﻴﺻﻮﺗ ﻲﻌﻄﻘﻣ ﺮﺑ يور 27 رﺎﻤﻴﺑ ﺎﺘﺑ ﻪﺑ ﻼﺘﺒﻣ روژﺎﻣ ﻲﻤﺳﻻﺎﺗ ) تﺎﺸﻳﺎﻣزآ ﻂﺳﻮﺗ هﺪﺷ ﻦﻴﻴﻌﺗ ﺎﺑ ،ﻲﻜﻴﻨﻴﻠﻛارﺎﭘ و ﻲﻜﻴﻨﻴﻠﻛ ﻲﻨﺳ ﺞﻧر 30 -10 لﺎﺳ ( ﺮﺟﺎﻫ ﻲﻤﺳﻻﺎﺗ ﻚﻴﻨﻴﻠﻛ ﻪﺑ هﺪﻨﻨﻛ ﻪﻌﺟاﺮﻣ رد دﺮﻛﺮﻬﺷ لﺎﺳ 1390 ﮔ ترﻮﺻ ﺖﻓﺮ . ﻲﻧﻮﺧ ﻢﻈﻨﻣ ﻖﻳرﺰﺗ ياراد نارﺎﻤﻴﺑ ﻪﻤﻫ ) ﺎﺑ ﻲﻧﺎﻣز ﻪﻠﺻﺎﻓ ﻦﻴﮕﻧﺎﻴﻣ 20 زور ( ﻦﻴﺑﻮﻠﮔﻮﻤﻫ ﻆﻔﺣ ﺖﻬﺟ gr/dl 10 و ﺪﻧدﻮﺑ ﺮﻳز لاﺮﻔﺳد زا ﺟ هدﺎﻔﺘﺳا يﺪﻠ ﻲﻣ ﺪﻧدﺮﻛ . ﺖﻴﺗﺎﭙﻫ ﺖﻧﻮﻔﻋ ﻪﻛ ﻲﻧارﺎﻤﻴﺑ B ﺎﻳ C ﻪﻘﺑﺎﺳ ، HIV ،نوﺮﭙﻳﺮﻓد ﺎﺑ ﻦﻫآ ﻊﻓد نﺎﻣرد ،ﺖﺒﺜﻣ ،ﻲﮕﻠﻣﺎﺣ ﻦﻴﻣﺎﺘﻳو فﺮﺼﻣ C ﻚﻴﻟﻮﻓﺪﻴﺳا ﺎﻳ 24 زا ﻞﺒﻗ ﺖﻋﺎﺳ يﺮﻴﮔ ﻪﻧﻮﻤﻧ ﺪﻧﺪﺷ جرﺎﺧ ﻪﻌﻟﺎﻄﻣ زا ﺪﻨﺘﺷاد . ﺪﻫﺎﺷ هوﺮﮔ هوﺮﮔ ﻚﻳ ﻞﻣﺎﺷ ﺰﻴﻧ 26 نوﺪﺑ ﻢﻟﺎﺳ داﺮﻓا زا هﺮﻔﻧ و ﻦﺳ ظﺎﺤﻟ زا ﻪﻛ ﺪﻧدﻮﺑ ﻲﻧﻮﺧ ﻢﻛ ﻪﻘﺑﺎﺳ ﻪﻧﻮﮕﭽﻴﻫ ﺪﻨﺘﺷاد ﺖﻘﺑﺎﻄﻣ نارﺎﻤﻴﺑ ﺎﺑ ﺲﻨﺟ ) ياراد ﻲﻨﺳ ﺞﻧر 31 -11 لﺎﺳ ( ، يروآ ﻊﻤﺟ نﺎﻣز تﺪﻣ لﻮﻃ رد ﻦﻴﻨﭽﻤﻫ نﺎﻨﻴﻤﻃا ﺎﻫ ﻪﻧﻮﻤﻧ ﻦﻣﺰﻣ يرﺎﻤﻴﺑ ﻪﻧﻮﮕﭽﻴﻫ ﻪﻛ ﺪﺷ ﻞﺻﺎﺣ ﺪﻨﺷﺎﺑ ﻪﺘﺷاﺪﻧ ﻲﻧﻮﻔﻋ دﺎﺣ و . ﻂﻳاﺮﺷ ياراد نارﺎﻤﻴﺑ ﻪﻤﻫ ﻪﻌﻟﺎﻄﻣ ﻦﻳا رد ﺖﻳﺎﺿر و دورو و ﺪﻧﺪﺷ هداد ﺖﻛﺮﺷ ﻪﻌﻟﺎﻄﻣ رد ﻪﻣﺎﻧ ﻪﻌﻟﺎﻄﻣ مﺎﺠﻧا ياﺮﺑ 5 زا ﻞﻣﺎﻛ نﻮﺧ ﻪﻧﻮﻤﻧ ﺮﺘﻴﻟ ﻲﻠﻴﻣ ﺪﺿ يوﺎﺣ يﺎﻫ ﻪﻟﻮﻟ رد ﺪﻫﺎﺷ هوﺮﮔ داﺮﻓا و نارﺎﻤﻴﺑ دﺎﻘﻌﻧا ﻢﻳﺪﺳ ﻦﻳرﺎﭙﻫ ﻤﺟ ﺪﺷ يروآ ﻊ ) رﺎﻤﻴﺑ نﻮﺧ ﻪﻧﻮﻤﻧ ﺪﺷ ﻪﺘﻓﺮﮔ نﻮﺧ ﻖﻳرﺰﺗ زا ﻞﺒﻗ .( يﺎﻫ لﻮﺒﻠﮔ ﺰﻴﻟ ﺖﻬﺟ ﺲﭙﺳ تﺪﻣ ﻪﺑ ﻪﻧﻮﻤﻧ ﺐﺳﺎﻨﻣ راﺪﻘﻣ يوﺎﺣ يﺎﻫ ﻪﻟﻮﻟ ،ﺰﻣﺮﻗ 15 ﺰﻴﻟ هدﺎﻣ ﺎﺑ قﺎﺗا يﺎﻣد رد ﻪﻘﻴﻗد هﺪﻨﻨﻛ FACS lysing
ﺪﻧﺪﺷ ﻪﺑﻮﻜﻧا . ﺲﭙﺳ د و ژﻮﻔﻳﺮﺘﻧﺎﺳ ﺎﻫ ﻪﻟﻮﻟ تﺎﻔﺴﻓ ﺮﻓﺎﺑ ر ﻦﻴﻟﺎﺳ ) Posphate buffered saline=PBS ( يوﺎﺣ ﻦﻴﻣﻮﺒﻟآ يوﺎﮔ مﺮﺳ 5 ﺪﺻرد BSA) (Bovine serum albumin= و 1 / 0 ﺪﺻرد ﺪﻧﺪﺷ هداد ﻮﺸﺘﺴﺷ ﺪﻳزآ ﻢﻳﺪﺳ . ﻪﻣادا رد ﺎﻫ لﻮﻠﺳ يﺎﻫ يدﺎﺑ ﻲﺘﻧآ ﺎﺑ ًﺎﻤﻴﻘﺘﺴﻣ تﺪﻣ ﻪﺑ لﺎﻧﻮﻠﻛﻮﻨﻣ 30 و قﺎﺗا يﺎﻣد رد ﻪﻘﻴﻗد ﻲﻜﻳرﺎﺗ و ﺪﻧﺪﺷ ﻪﺑﻮﻜﻧا ﺎﺑ ﻮﺸﺘﺴﺷ زا ﺲﭘ PBS يوﺎﺣ 5 ﺪﺻرد BSA و 1 / 0 ﺪﺻرد ﻢﻳﺪﺳ ﺰﻴﻟﺎﻧآ درﻮﻣ ﺪﻳزآ ﺪﻨﺘﻓﺮﮔ راﺮﻗ ﻚﻳﺮﺘﻣﻮﺘﻳﺎﺳﻮﻠﻓ ) 15 (. ﻪﻧﻮﻤﻧ اﺪﺘﺑا ،ﺖﻛﻼﭘ ندﺮﻛ جرﺎﺧ ﺖﻬﺟ ﺎﻫ ﻲﺘﻴﺳﻮﻔﻨﻟ ﺖﻴﻌﻤﺟ يزﺎﺳاﺪﺟ و ﺎﻫ ﺖﻴﺳﻮﻨﻣ ،ﺎﻫ ﺖﻴﺳﻮﻟﻮﻧاﺮﮔ رادﻮﻤﻧ يور FSC/SSC ﺪﻧﺪﺷ اﺪﺟ . ﻞﻗاﺪﺣ ﺐﻴﺗﺮﺗ ﻦﻳﺪﺑ 30000 ﺪﻣآ ﺖﺳﺪﺑ ﺎﻫ ﺖﻴﺳﻮﻔﻨﻟ ﻪﻴﺣﺎﻧ رد لﻮﻠﺳ . ﺲﭙﺳ يﺎﻫ ﺖﻴﺳﻮﻔﻨﻟ CD3+ ﻓ تﺪﺷ يور زا ﺲﻨﺳرﻮﻠ PE ﺺﺨﺸﻣ ، زا يﺮﺘﻣارﺎﭘ ود يا ﻪﻄﻘﻧ رادﻮﻤﻧ و ﺪﻧﺪﺷ CD4 و CD8 رد ﻞﺑﺎﻘﻣ CD27 رد ﺮﻈﻧ درﻮﻣ يﺰﻴﻣآ ﮓﻧر ﺪﺻرد ﺶﻳﺎﻤﻧ ﺖﻬﺟ هدر ﺮﻳز ود CD4+ و CD8+ ﺪﺷ ﻢﻴﺳﺮﺗ . ﺰﻴﻟﺎﻧآ ﺎﻬﺘﻧا رد راﺰﻓا مﺮﻧ ﻂﺳﻮﺗ ﻚﻳﺮﺘﻣﻮﺘﻳﺎﺳﻮﻠﻓ FLOMAX ﺖﻓﺮﮔ ترﻮﺻ . ﻪﻌﻟﺎﻄﻣ رد هدﺎﻔﺘﺳا درﻮﻣ لﺎﻧﻮﻠﻛﻮﻨﻣ يﺎﻫ يدﺎﺑ ﻲﺘﻧآ ﺖﻛﺮﺷ زا Becton Dickenson ﻞﻣﺎﺷ ﻪﻛ ﺪﻧﺪﺷ يراﺪﻳﺮﺧ :
Anti-CD4 (APC), Anti-CD8 (PE-cy5), Anti-CD3 (PE), Anti-CD27 FITC Control isotypes; MS IgG1κ, MS IgG2bκ ﺪﻧدﻮﺑ . ،ﺖﻳﺎﻬﻧ رد ﻪﺟﻮﺗ ﺎﺑ درﻮﻣ ﺮﻫ رد ﺎﻫ لﻮﻠﺳ داﺪﻌﺗ و يﺮﺘﻣﻮﺘﻳﺎﺳﻮﻠﻓ زا هﺪﻣآ ﺖﺳﺪﺑ يﺎﻫ هداد ﻪﺑ آ ﺰﻴﻟﺎﻧ ﻓا مﺮﻧ راﺰ FLOMAX ﻲﻧﻮﺧ ﻞﻣﺎﻛ شرﺎﻤﺷ ﺰﻴﻧ و ﻪﺒﺳﺎﺤﻣ و ﺪﻳدﺮﮔ رد ﺎﻫ هداد يرﺎﻣآ راﺰﻓا مﺮﻧ SPSS ﺑ و ﺎ ا ﺳ ﻔﺘ ﺎ زا هد نﻮﻣزآ يرﺎﻣآ يﺎﻫ Mann-Withney ﻦﻣﺮﻴﭙﺳا ﻲﮕﺘﺴﺒﻤﻫ و ﺪﻧﺪﺷ ﻞﻴﻠﺤﺗ و ﻪﻳﺰﺠﺗ . ﺎﻫ ﻪﺘﻓﺎﻳ : ار ﻪﻌﻟﺎﻄﻣ رد هﺪﻨﻨﻛ ﺖﻛﺮﺷ نارﺎﻤﻴﺑ 27 ﺎﺑ ﺮﻔﻧ ﻲﻨﺳ ﻦﻴﮕﻧﺎﻴﻣ 02 / 5 ± 7 / 17 داد ﻲﻣ ﻞﻴﻜﺸﺗ ﺪﻧ ﻛ ﻪ 63 ﺪﺻرد آ ن ﺪﻧدﻮﺑ دﺮﻣ ﺎﻫ . ﻚﻳ ﻞﻣﺎﺷ ﺰﻴﻧ ﺪﻫﺎﺷ هوﺮﮔ هوﺮﮔ 26 ﻲﻨﺳ ﻦﻴﮕﻧﺎﻴﻣ ﺎﺑ ﻢﻟﺎﺳ داﺮﻓا زا هﺮﻔﻧ 1 / 6 ± 6 / 19 ﻞﻣﺎﺷ 7 / 57 ﺪﺻرد ﺪﻧدﻮﺑ دﺮﻣ . رد نﻮﺧ ﻖﻳرﺰﺗ ﻪﻠﺻﺎﻓ نارﺎﻤﻴﺑ 3 / 0 ± 2 / 3 مﺮﺳ ﻦﻴﺘﻳﺮﻓ ناﺰﻴﻣ ،ﻪﺘﻔﻫ ng/dl 8 / 954 ± 3 / 1529 لاﺮﻔﺳد فﺮﺼﻣ ناﺰﻴﻣ و 8 / 0 ± 2 / 5 دﻮﺑ ﻪﺘﻔﻫ رد ﺐﺷ . ﺗ ﺪﻴﻔﺳ يﺎﻫ لﻮﺒﻠﮔ داﺪﻌ ) WBC ( نارﺎﻤﻴﺑ رد ﻦﻴﺑ يرﺎﻣآ راد ﻲﻨﻌﻣ ﻪﻄﺑار ﺎﻣا ،دﻮﺑ ﺪﻫﺎﺷ هوﺮﮔ زا ﺶﻴﺑ شرﺎﻤﺷ WBC نارﺎﻤﻴﺑ ) 5 / 8733 ± 10 / 8594 رد ﺮﺘﻤﻴﻠﻴﻣ ﺐﻌﻜﻣ ( ﺪﻫﺎﺷ هوﺮﮔ ﺎﺑ ﻪﺴﻳﺎﻘﻣ رد ) 98 / 818 ± 13 / 5134 رد ﺐﻌﻜﻣ ﺮﺘﻤﻴﻠﻴﻣ ( ﺪﺸﻧ هﺪﻫﺎﺸﻣ ) 05 / 0 > P .( رد نارﺎﻤﻴﺑ رد ﻨﻟ ﺪﻫﺎﺷ هوﺮﮔ ﺎﺑ ﻪﺴﻳﺎﻘﻣ ﺪﺷ هﺪﻫﺎﺸﻣ يﺮﻴﮕﻤﺸﭼ زﻮﺘﻴﺳﻮﻔ ) 001 / 0 < P .( يﺎﻫ ﺖﻴﺳﻮﻔﻨﻟ ﺪﺻرد ﻲﻓﺮﻃ زا T رد نارﺎﻤﻴﺑ ) 02 / 24 ± 63 / 28 ( ﺪﻫﺎﺷ هوﺮﮔ ﺎﺑ ﻪﺴﻳﺎﻘﻣ رد ) 87 / 14 ± 81 / 54 ( ﺖﺷاد يرادﺎﻨﻌﻣ رﺎﻴﺴﺑ ﺶﻫﺎﻛ ) 001 / 0 < P .( يﺎﻫ لﻮﻠﺳ ﻖﻠﻄﻣ داﺪﻌﺗ و ﺪﺻرد CD4+ و CD8+ ﺮﻴﻴﻐﺗ ﺪﻫﺎﺷ هوﺮﮔ ﺎﺑ ﻪﺴﻳﺎﻘﻣ رد نارﺎﻤﻴﺑ رد يراد ﻲﻨﻌﻣ داﺪﻧ نﺎﺸﻧ ) 05 / 0 > P ) ( هرﺎﻤﺷ لوﺪﺟ 1 ( . ﻴﻣ ــــ ﻌﺗ ﺶﻫﺎﻛ ناﺰ ـــ ﻔﻨﻟ داﺪ ــــ ﺖﻴﺳﻮ CD3+CD4+CD27+ ﺪﻫﺎﺷ هوﺮﮔ ﻪﺑ ﺖﺒﺴﻧ نارﺎﻤﻴﺑ رد رﻮﻃ ﻪﺑ ﻳﺰﺟ ﻲﻨﻌﻣ ﻲ دﻮﺑ راد ) 07 / 0 = P ( داﺪﻌﺗ ﺎﻣا ، ﺖﻴﺳﻮﻔﻨﻟ يﺎﻫ CD3+CD8+CD27+ يﺮﻴﮕﻤﺸﭼ توﺎﻔﺗ ﺖﺷاﺪﻧ ﺪﻫﺎﺷ هوﺮﮔ ﻪﺑ ﺖﺒﺴﻧ نارﺎﻤﻴﺑ رد ) 05 / 0 > P ( ) هرﺎﻤﺷ لوﺪﺟ 2 .( ﺎﻫ ﺖﻴﺳﻮﻔﻨﻟ داﺪﻌﺗ راد ﻲﻨﻌﻣ ﺶﻫﺎﻛ ﻪﺑ ﻪﺟﻮﺗ ﺎﺑ ،ﻦﻴﺘﻳﺮﻓ ناﺰﻴﻣ ،ﻦﺳ ﺮﻴﺛﺄﺗ ،ﺪﻫﺎﺷ هوﺮﮔ ﻪﺑ ﺖﺒﺴﻧ نارﺎﻤﻴﺑ رد داﺪﻌﺗ ﺮﺑ ﻲﻓﺮﺼﻣ لاﺮﻔﺳد ناﺰﻴﻣ و نﻮﺧ ﻖﻳرﺰﺗ يﺎﻫ ﺖﻴﺳﻮﻔﻨﻟ T تاﺮﻴﻴﻐﺗ و ﺖﻓﺮﮔ راﺮﻗ ﻲﺳرﺮﺑ درﻮﻣ لﻮﻠﺳ داﺪﻌﺗ ﺎﺑ قﻮﻓ دراﻮﻣ زا ﻚﻳ ﭻﻴﻫ T ﻲﮕﺘﺴﺒﻤﻫ ﺖﺷاﺪﻧ يراد ﻲﻨﻌﻣ ) 05 / 0 > P .( يﺎﻫ ﺖﻴﺳﻮﻔﻨﻟ داﺪﻌﺗ ﻦﻴﻨﭽﻤﻫ + CD3+CD4+CD27 فﺮﺼﻣ و نﻮﺧ ﻖﻳرﺰﺗ ناﺰﻴﻣ ﺎﺑ ﻔﺳد ـــ ﻨﻌﻣ سﻮﻜﻌﻣ ﻲﮕﺘﺴﺒﻤﻫ لاﺮ ـــ ﻲ ﺖﺷاد يراد ) 05 / 0 < P ( ﺖﻴﻌﻤﺟ ﻦﻳا ﻦﻴﺑ ﻲﮕﺘﺴﺒﻤﻫ ﻦﻳا ﻪﻛ ﻲﻟﺎﺣ رد ، داﺪﻌﺗ و ﺖﺷاﺪﻧ دﻮﺟو ﻦﻴﺘﺑﺮﻓ ناﺰﻴﻣ و ﻦﺳ ﺎﺑ ﻲﻟﻮﻠﺳ ﺖﻴﺳﻮﻔﻨﻟ CD3+CD8+CD27+ زا ﺮﻴﻏ ﺺﺧﺎﺷ ﻪﻴﻠﻛ ﺎﺑ ﻴﻣ ـــ ﻓ ناﺰ ـــ ﺖﺷاد يراد ﻲﻨﻌﻣ سﻮﻜﻌﻣ ﻲﮕﺘﺴﺒﻤﻫ ﻦﻴﺘﻳﺮ ) هرﺎﻤﺷ لوﺪﺟ 3 (.
هرﺎﻤﺷ لوﺪﺟ 1 : ﻪﺴﻳﺎﻘﻣ نارﺎﻤﻴﺑ رد ﻚﻳژﻮﻟﻮﻨﻤﻳا يﺎﻫ ﺺﺧﺎﺷ روژﺎﻣ ﻲﻤﺳﻻﺎﺗ ﻪﺑ ﻼﺘﺒﻣ ﺎﺑ ﻪﺴﻳﺎﻘﻣ رد هوﺮﮔ ﺪﻫﺎﺷ ﺎﻫ هوﺮﮔ ﻚﻳژﻮﻟﻮﻨﻤﻳا يﺎﻫ ﺺﺧﺎﺷ رﺎﻤﻴﺑ ) 27 ﺮﻔﻧ ( ﺪﻫﺎﺷ ) 26 ﺮﻔﻧ ( اد ﻲﻨﻌﻣ ﺢﻄﺳ ير ﺐﻌﻜﻣ ﺮﺘﻤﻴﻠﻴﻣ رد ﺖﻴﺳﻮﻛﻮﻟ داﺪﻌﺗ 5 / 8733 ± 10 / 8594 89 / 818 ± 13 / 5134 05 / 0 > ﺐﻌﻜﻣ ﺮﺘﻤﻴﻠﻴﻣ رد ﺖﻴﺳﻮﻔﻨﻟ داﺪﻌﺗ 22 / 7984 ± 6 / 6204 7 / 543 ± 21 / 2122 001 / 0 < ﺖﻴﺳﻮﻔﻨﻟ ﺪﺻرد CD3+ 02 / 24 ± 63 / 28 87 / 14 ± 81 / 54 001 / 0 < ﺖﻴﺳﻮﻔﻨﻟ داﺪﻌﺗ CD4+T ﺐﻌﻜﻣ ﺮﺘﻤﻴﻠﻴﻣ رد 13 / 45 ± 73 / 576 5 / 294 ± 15 / 644 05 / 0 > ﺖﻴﺳﻮﻔﻨﻟ داﺪﻌﺗ CD8+T ﺐﻌﻜﻣ ﺮﺘﻤﻴﻠﻴﻣ رد 17 / 201 ± 35 / 405 44 / 155 ± 04 / 417 05 / 0 > ﺖﺒﺴﻧ CD4/CD8 * 42 / 1 * 54 / 1 05 / 0 > ترﻮﺻ ﻪﺑ ﺎﻫ هداد " ﻦﻴﮕﻧﺎﻴﻣ ± رﺎﻴﻌﻣ فاﺮﺤﻧا " ﺪﻨﺷﺎﺑ ﻲﻣ ؛ CD : يﺰﻳﺎﻤﺗ ﻪﺘﺳد ؛ * ﺪﻧا هﺪﺷ نﺎﻴﺑ ﺖﺒﺴﻧ ترﻮﺻ ﻪﺑ ﺎﻫ هداد . هرﺎﻤﺷ لوﺪﺟ 2 : ﻪﺴﻳﺎﻘﻣ ﺰﻴﻣ يﺎﻫ ﺖﻴﺳﻮﻔﻨﻟ نا CD27+ نارﺎﻤﻴﺑ رد روژﺎﻣ ﻲﻤﺳﻻﺎﺗ ﻪﺑ ﻼﺘﺒﻣ ﺪﻫﺎﺷ هوﺮﮔ و ﺎﻫ هوﺮﮔ لﻮﻠﺳ عﻮﻧ رﺎﻤﻴﺑ ) 27 ﺮﻔﻧ ( ﺪﻫﺎﺷ ) 26 ﺮﻔﻧ ( ﻨﻌﻣ ﺢﻄﺳ ﻲ يراد ﺖﻴﺳﻮﻔﻨﻟ CD3+CD4+CD27+ 45 / 196 ± 71 / 275 33 / 255 ± 95 / 476 07 / 0 ﺖﻴﺳﻮﻔﻨﻟ CD3+CD8+CD27+ 68 / 160 ± 83 / 236 34 / 119 ± 68 / 298 32 / 0 ترﻮﺻ ﻪﺑ ﺎﻫ هداد " ﻦﻴﮕﻧﺎﻴﻣ ± رﺎﻴﻌﻣ فاﺮﺤﻧا " ﺪﻨﺷﺎﺑ ﻲﻣ ؛ CD : يﺰﻳﺎﻤﺗ ﻪﺘﺳد . هرﺎﻤﺷ لوﺪﺟ 3 : يﺎﻫ ﺖﻴﺳﻮﻔﻨﻟ شرﺎﻤﺷ ﻦﻴﺑ ﻲﮕﺘﺴﺒﻤﻫ ﺞﻳﺎﺘﻧ T يﺎﻫ ﺖﻴﺳﻮﻔﻨﻟ و T CD27+ روژﺎﻣ ﻲﻤﺳﻻﺎﺗ ﻪﺑ ﻼﺘﺒﻣ نارﺎﻤﻴﺑ رد CD : ﺰﻳﺎﻤﺗ ﻪﺘﺳد رﻮﺘﻛﺎﻓ ﻂﺒﺗﺮﻣ يﺎﻫ لﻮﻠﺳ عﻮﻧ ﻦﺳ ﻦﻴﺘﻳﺮﻓ ناﺰﻴﻣ نﻮﺧ ﻖﻳرﺰﺗ ناﺰﻴﻣ لاﺮﻔﺳد فﺮﺼﻣ ناﺰﻴﻣ ﻲﮕﺘﺴﺒﻤﻫ ﺐﻳﺮﺿ 27 / 0 -13 / 0 26 / 0 -11 / 0 ﺖﻴﺳﻮﻔﻨﻟ T شزرا P 17 / 0 54 / 0 18 / 0 60 / 0 ﻲﮕﺘﺴﺒﻤﻫ ﺐﻳﺮﺿ 29 / 0 -055 / 0 -62 / 0 -71 / 0 ﺖﻴﺳﻮﻔﻨﻟ CD3+CD4+CD27+ شزرا P 18 / 0 89 / 0 04 / 0 02 / 0 ﻲﮕﺘﺴﺒﻤﻫ ﺐﻳﺮﺿ 43 / 0 -19 / 0 -65 / 0 -71 / 0 ﺖﻴﺳﻮﻔﻨﻟ CD3+CD8+CD27+ شزرا P 04 / 0 60 / 0 03 / 0 02 / 0
ﺚﺤﺑ : نارﺎﻤﻴﺑ رد ﻲﻜﻳژﻮﻟﻮﻨﻤﻳا يﺎﻫ يرﺎﺠﻨﻫﺎﻧ دﻮﺟو ﺎﺘﺑ ﻪﺑﻼﺘﺒﻣ يزﺎﺳ لﺎﻌﻓ رد ﺺﻘﻧ ﺮﻴﻈﻧ روژﺎﻣ ﻲﻤﺳﻻﺎﺗ دﺮﻜﻠﻤﻋ و داﺪﻌﺗ رد ﺮﻴﻴﻐﺗ ،ژﺎﻓوﺮﻛﺎﻣ ﺖﻴﻟﺎﻌﻓ و نﺎﻤﻠﭙﻤﻛ ﺖﻴﺳﻮﻔﻨﻟ ﺗ رد ﺺﻘﻧ و ﺎﻫ هﺪﺷ شراﺰﮔ ﺎﻫ ﻦﻴﻛﻮﺘﻳﺎﺳ ﺪﻴﻟﻮ ﺖﺳا ) 16 ( . يرﺎﺠﻨﻫﺎﻧ ﻦﻳا ﻖﻴﻗد ﻢﺴﻴﻧﺎﻜﻣ ﺺﺨﺸﻣ ﺎﻫ ﺖﺴﻴﻧ ، دﺪﻌﺘﻣ تﺎﻘﻳرﺰﺗ ،ﻦﻫآ رﺎﺑ ﻪﻓﺎﺿا ﺎﺑ ﺖﺳا ﻦﻜﻤﻣ ﺎﻣا نژ ﻲﺘﻧآ دورو و نﻮﺧ زا هدﺎﻔﺘﺳا و نﺪﺑ ﻪﺑ ﻚﻴﻧژﻮﻟآ يﺎﻫ ﺪﺷﺎﺑ ﻪﺘﺷاد طﺎﺒﺗرا ﻦﻫآ هﺪﻨﻨﻛ ﻊﻓد ﻞﻣاﻮﻋ ) 9،17،18 .( رد ﻣ ﺰﻴﻧ و هﺪﺷ يرادﺮﺑ لﺎﺤﻃ نارﺎﻤﻴﺑ يرﺎﻛ ﻢﻛ ﻪﺑ ﻼﺘﺒ ﻲﻤﺳﻻﺎﺗ نارﺎﻤﻴﺑ رد و ﺪﻳآ ﻲﻣ دﻮﺟو ﻪﺑ زﻮﺘﻴﺳﻮﻔﻨﻟ لﺎﺤﻃ ﻲﺘﻧآ مواﺪﻣ تﺎﻜﻳﺮﺤﺗ ﺎﺑ ﺰﻴﻧ و لﺎﺤﻃ ﺖﺷادﺮﺑ ﺎﺑ ﺪﻧاﻮﺗ ﻲﻣ ﻚﻴﻧژ ﺪﺷﺎﺑ ﻪﺘﺷاد طﺎﺒﺗرا ) 10 ( . لﺎﺤﻃ ندﺮﻛ جرﺎﺧ ﺖﻴﺳﻮﻔﻨﻟ ﻪﻴﻠﺨﺗ ﺐﺟﻮﻣ ﺪﻧاﻮﺗ ﻲﻣ يﺎﻫ T د نارﺎﻤﻴﺑ ﻦﻳا ر ددﺮﮔ ) 19 (. ﺖﺒﺴﻧ ﺎﻣ ﻪﻌﻟﺎﻄﻣ رد CD4/CD8 ﺮﻴﻴﻐﺗ ﻨﻌﻣ ﻲ يراد ﻂﺳﻮﺗ ﻪﻛ يا ﻪﻌﻟﺎﻄﻣ ﺎﺑ ﻪﻛ ﺖﺷاﺪﻧ ﺪﻫﺎﺷ ﺎﺑ Hodg و نارﺎﻤﻴﺑ زا ﻲﻤﻛ ﺪﺻرد رد ﺎﻬﻨﺗ و هﺪﺷ مﺎﺠﻧا نارﺎﻜﻤﻫ ﺖﺳا هﺪﺷ سﻮﻜﻌﻣ ﺖﺒﺴﻧ ، دراد ﻲﻳﻮﺳ ﻢﻫ ) 20 ( رد ، ﺖﺒﺴﻧ ﻦﻳا نﺪﺷ سﻮﻜﻌﻣ يﺮﮕﻳد تﺎﻌﻟﺎﻄﻣ رد ﻪﻛ ﻲﻟﺎﺣ ﺖﺳا هﺪﺷ شراﺰﮔ ) 21 ( . درﻮﻣ نارﺎﻤﻴﺑ ﻪﻜﻨﻳا ﻪﺑ ﻪﺟﻮﺗ ﺎﺑ ﺮﻈﻧ زا ﺎﻣ ﻪﻌﻟﺎﻄﻣ ﺖﻴﺗﺎﭙﻫ B و C ،ﺪﻧدﻮﺑ ﻲﻔﻨﻣ عﻮﺿﻮﻣ ﻦﻳا ﻲﻣ ﻲﻌﻴﺒﻃ ﺖﺒﺴﻧ ﺪﻧاﻮﺗ CD4/CD8 ﺮﻴﺴﻔﺗ يﺪﺣ ﺎﺗ ار ﺪﻳﺎﻤﻧ . ﺖﻴﺳﻮﻔﻨﻟ داﺪﻌﺗ ﻦﻴﺑ ﻲﮕﺘﺴﺒﻤﻫ ﻲﺳرﺮﺑ رد يﺎﻫ T فﺮﺼﻣ و نﻮﺧ ﻖﻳرﺰﺗ ،ﻦﻴﺘﻳﺮﻓ ناﺰﻴﻣ ،نارﺎﻤﻴﺑ ﻦﺳ و ﺪﻳدﺮﮕﻧ هﺪﻫﺎﺸﻣ يراد ﻲﻨﻌﻣ طﺎﺒﺗرا لاﺮﻔﺳد . ﻪﺑ ﻪﺟﻮﺗ ﺎﺑ اﺪﻌﺗ لﺮﺘﻨﻛ رد ﻲﺳﺎﺳا ﺶﻘﻧ لﺎﺤﻃ ﻪﻜﻨﻳا لﻮﻠﺳ د T دراد ،نارﺎﻤﻴﺑ ﻦﻴﺑ رد و 12 ﻦﻳا ،ﺪﻧا هﺪﺷ يرادﺮﺑ لﺎﺤﻃ ﺮﻔﻧ ﺗ ﺖﺤﺗ ار ﺮﮕﻳد يﺎﻫرﻮﺘﻛﺎﻓ ﺶﻘﻧ ﺪﻧاﻮﺗ ﻲﻣ عﻮﺿﻮﻣ ﺛﺄ ﺮﻴ ﺪﻫد راﺮﻗ . نﺎﻴﺑ ﺮﻴﻴﻐﺗ ﺮﺿﺎﺣ ﻪﻌﻟﺎﻄﻣ ﻪﺘﺴﺟﺮﺑ تﺎﻜﻧ زا ﻲﻜﻳ CD27 ﺖﻴﺳﻮﻔﻨﻟ ﺢﻄﺳ ﺮﺑ T دﻮﺑ . لﻮﻠﺳ يا هﺮﻃﺎﺧ يﺎﻫ ﺟا ــــ ﻲﻳاﺮ CD27-ﻨﺘﺴﻫ ــ ﺪ ) 22 ( د دﻮﺷ ﻲﻣ رﻮـــﺼﺗ و ر ﺪﻨﻫد ﻲﻣ ﺖﺳد زا ار لﻮﻜﻟﻮﻣ ﻦﻳا نژ ﻲﺘﻧآ ﺎﺑ درﻮﺧﺮﺑ . رد ﺎﺳ داﺮﻓا ﻟ يﺎﻫ ﺖﻴﺳﻮﻔﻨﻟ ﺢﻄﺳ رد نآ نﺎﻴﺑ ﺶﻫﺎﻛ هدرﻮﺨ T ﺖﺳا هﺪﺷ هﺪﻳد ) 23 ( لﻮﻠﺳ ﻦﻳا ﺮﺑ هوﻼﻋ و ياراد يﺎﻫ يﻻﺎﺑ ناﺰﻴﻣ CD27 ﻲﺻﺎﺼﺘﺧا يﺎﻫ ﺖﻴﺳﻮﻔﻨﻟ ﻦﻴﺑ رد ﺖﺳا هﺪﺸﻧ ﺖﻓﺎﻳ سوﺮﻳو ) 24 ( زا ﺲﭘ ﺪﻫد ﻲﻣ نﺎﺸﻧ ﻪﻛ ﺎﺑ درﻮﺧﺮﺑ ﻧآ ﻲﺘ هداد ﺖﺳد زا ار نآ ﺎﻫ ﺖﻴﺳﻮﻔﻨﻟ ﻦﻳا نژ ﺪﻧا . ﺮﻫ ﻲﻨﻌﻳ ﻲﻳاﺮﺟا يا هﺮﻃﺎﺧ لﻮﻠﺳ ﻪﺘﺳد ود CD45RO+ و CD45RA+ ﺮﻈﻧ زا CD27 ﺪﻨﺘﺴﻫ ﻲﻔﻨﻣ ) 25 ( . يﺎﻫ لﻮﻠﺳ رد B يﺎﻫ ﺖﻴﺳﻮﻔﻨﻟ هوﺮﮔ ﺮﻳز ﺰﻴﻧ ﺪﺑﺎﻳ ﻲﻣ ﺶﻳاﺰﻓا ﻦﺳ ﺶﻳاﺰﻓا ﺎﺑ ) 26 ( . رد ﻂﺳﻮﺗ هﺪﺷ مﺎﺠﻧا ﻪﻌﻟﺎﻄﻣ Alboreda ﺰﻴﻧ نارﺎﻜﻤﻫ و ﺎﻫ لﻮﻠﺳ زا ﻲﻳﻻﺎﺑ ﺪﺻرد ي CD45RA- نرﺎﻤﻴﺑ رد آ ﺖﺳا هﺪﺷ هﺪﻳد موزﻮﻧﺎﭙﻳﺮﺗ ﻪﺑ هدﻮﻟ ) 27 ( . رد ﺖﻧﻮﻔﻋ HIV ياراد سوﺮﻳو ﺮﺗﻻﺎﺑ زود ﺎﺑ نارﺎﻤﻴﺑ عﻮﻧ زا يﺮﺘﺸﻴﺑ ﻲﻟﻮﻠﺳ ﺖﻴﻌﻤﺟ CD27- CCR7-CD45RO+ ﺪﻨﺘﺴﻫ ) 28 ( . قﻮﻓ تﺎﻌﻟﺎﻄﻣ ﻪﻴﻠﻛ رد ﻲﺘﻧآ ﻦﻣﺰﻣ يﺎﻫدرﻮﺧﺮﺑ ﻚﻴﻧژ ﺗ ﺄ ﻴﺑ ﺮﺑ ﻲﻔﻨﻣ ﺮﻴﺛ نﺎ لﻮﻜﻟﻮﻣ CD27 رد و ﺖﺳا ﻪﺘﺷاد ﺎﻫ ﺖﻴﺳﻮﻔﻨﻟ ﺢﻄﺳ رد ناﺰﻴﻣ ﺰﻴﻧ ﺎﻣ ﻪﻌﻟﺎﻄﻣ ﺮﻫ رد نارﺎﻤﻴﺑ رد لﻮﻜﻟﻮﻣ ﻦﻳا زوﺮﺑ ﺖﻴﻌﻤﺟ ود CD4 و CD8 دﻮﺑ ﺪﻫﺎﺷ هوﺮﮔ زا ﺮﺘﻤﻛ ه ﺖﺳا توﺎﻔﺗ ﻦﻳا ﺪﻨﭼ ﺮﻫ ، ﺗ هوﺮﮔ ﺮﻳز رد ﺎﻬﻨ CD4 ﻪﺑ ﺰﺟ رﻮﻃ ﻳ ﻨﻌﻣ ﻲ ﻲ درﻮﺧﺮﺑ ﺖﻠﻋ ﻪﺑ ﺪﻧاﻮﺗ ﻲﻣ ﻪﻛ دﻮﺑ راد نژ ﻲﺘﻧآ ﺎﺑ ﻦﻣﺰﻣ يﺎﻫ لﺎﻘﺘﻧا ﺖﻠﻋ ﻪﺑ ﻪﻠﻤﺟ زا ﻒﻠﺘﺨﻣ ﺪﺷﺎﺑ ﻚﻴﻧژﻮﻟآ نﻮﺧ . نارﺎﻤﻴﺑ دوﺪﺤﻣ داﺪﻌﺗ ﻪﺑ ﻪﺟﻮﺗ ﺎﺑ ﻪﺑ زﺎﻴﻧ ﺪﻳﺎﺷ ،ﭗﻴﺗﻮﺘﻓ ﻦﻳا ﻲﺳرﺮﺑ ﺖﻬﺟ ﻪﻌﻟﺎﻄﻣ درﻮﻣ ﺪﺷﺎﺑ ﻪﻨﻴﻣز ﻦﻳا رد يﺮﺘﺸﻴﺑ ﻲﺳرﺮﺑ . ﺮﺿﺎﺣ ﻪﻌﻟﺎﻄﻣ رد هوﺮﮔ ﺮﻳز رد CD4 ناﺰﻴﻣ ﻦﻴﺑ لﻮﻠﺳ ﻦﻳا طﺎﺒﺗرا لاﺮﻔﺳد فﺮﺼﻣ و نﻮﺧ ﻖﻳرﺰﺗ ﺎﺑ ﺎﻫ ﻲﻨﻌﻣ راد ي ﺎﺸﻣ ﺪﻳدﺮﮔ هﺪﻫ . ﻦﻴﻨﭽﻤﻫ ناﺰﻴﻣ ﻦﻴﺑ ﺖﻴﺳﻮﻔﻨﻟ يﺎﻫ CD27+T ﻲﻔﻨﻣ ﻲﮕﺘﺴﺒﻤﻫ نارﺎﻤﻴﺑ ﻦﺳ و ﺖﻴﺳﻮﻔﻨﻟ ﺖﻴﻌﻤﺟ رد ﻪﻛ ﺖﺷاد دﻮﺟو CD8 ﺢﻄﺳ ﻪﺑ ﺪﻴﺳر يراد ﻲﻨﻌﻣ . ناﺰﻴﻣ ﻦﺳ ﺶﻳاﺰﻓا ﺎﺑ ﻪﻜﻨﻳا ﻪﺑ ﻪﺟﻮﺗ ﺎﺑ ﺶﻳاﺰﻓا نارﺎﻤﻴﺑ ﻦﻳا رد ًﺎﺻﻮﺼﺧ ﺎﻫ نژ ﻲﺘﻧآ ﺎﺑ درﻮﺧﺮﺑ
ﺖﺳا رﺎﻈﺘﻧا ﻞﺑﺎﻗ ﻪﺘﻓﺎﻳ ﻦﻳا ،دراد . داﺪﻌﺗ ﻲﻓﺮﺼﻣ نﻮﺧ ﺪﺣاو يﺎﻫ ﺖﻴﺳﻮﻔﻨﻟ داﺪﻌﺗ ﺎﺑ CD27 هوﺮﮔ ود ﺮﻫ رد ﺖﺒﺜﻣ ﺖﻴﺳﻮﻔﻨﻟ يﺎﻫ CD4 و CD8 ﺖﺷاد ﻲﻔﻨﻣ ﻲﮕﺘﺴﺒﻤﻫ . ﺎﺑ ﻲﻨﻤﻳا ﻢﺘﺴﻴﺳ نﻮﺧ ﺪﺣاو ﺮﻫ ﻖﻳرﺰﺗ ﻪﻜﻨﻳا ﻦﺘﻓﺮﮔ ﺮﻈﻧ رد ،ﺪﻫد راﺮﻗ ﻚﻴﻧژﻮﻟآ يﺎﻫ نژ ﻲﺘﻧآ ضﺮﻌﻣ رد ار ﻦﻳا ﺖﻴﺳﻮﻔﻨﻟ ناﺰﻴﻣ ﺶﻫﺎﻛ ﺎﺑ ﺪﻧاﻮﺗ ﻲﻣ هﺪﻳﺪﭘ يﺎﻫ CD3+CD27+ طﺎﺒﺗرا ﺪﺷﺎﺑ ﻪﺘﺷاد . ﺮﺑ ﺪﻧاﻮﺗ ﻲﻣ ﻦﻴﺘﻳﺮﻓ ﺶﻳاﺰﻓا ﺪﻨﭼ ﺮﻫ ًاﺮﻫﺎﻇ ﺎﻣا ،ﺪﺷﺎﺑ ﻪﺘﺷاد ﻲﻔﻨﻣ ﺮﺛا ﻲﻨﻤﻳا ﻢﺘﺴﻴﺳ دﺮﻜﻠﻤﻋ ﺮﺑ ﭗﻴﺗﻮﺘﻓ نﺎﻴﺑ CD27 ﺖﻴﺳﻮﻔﻨﻟ رد T ﺗ ﺄ ﺖﺳا ﻪﺘﺷاﺪﻧ يﺮﻴﺛ ﭗﻴﺗﻮﺘﻓ ﻦﻳا و ﻦﻴﺘﻳﺮﻓ ناﺰﻴﻣ ﻦﻴﺑ يراد ﻲﻨﻌﻣ ﻲﮕﺘﺴﺒﻤﻫ و ﺪﺸﻧ ﺖﻓﺎﻳ . هﺮﻴﺧذ ﺎﺑ ﻪﻜﻨﻳا ﺮﺑ هوﻼﻋ ﻦﻴﺘﻳﺮﻓ ﻪﻜﻨﻳا ﻪﺑ ﻪﺟﻮﺗ ﺎﺑ ﻂﻳاﺮﺷ زا ﻲﻀﻌﺑ و تﺎﺑﺎﻬﺘﻟا رد ،دراد طﺎﺒﺗرا نﺪﺑ ﻦﻫآ صﻮﺼﺧ رد ﺪﻳﺎﺑ ،ﺪﺑﺎﻳ ﻲﻣ ﺶﻳاﺰﻓا ﺰﻴﻧ ﺮﮕﻳد ﻚﻳژﻮﻟﻮﺗﺎﭘ ﻴﻴﻐﺗ ﺮﺑ نآ ﺮﻴﺛﺄﺗ ـــ ﻳز تاﺮ ــــ هوﺮﮔ ﺮ ﺖﻴﺳﻮﻔﻨﻟ يﺎﻫ ﺎﻫ دﺮﻴﮔ ترﻮﺻ يﺮﺘﺸﻴﺑ يﺎﻫ ﻲﺳرﺮﺑ . ﻪﺠﻴﺘﻧ يﺮﻴﮔ : ﺮﺑ ﻧ سﺎﺳا ﺞﻳﺎﺘ ﻪﻌﻟﺎﻄﻣ ﻦﻳا ﻪﺑ ﻼﺘﺒﻣ نارﺎﻤﻴﺑ ﺖﻴﺗﺎﭙﻫ ﺮﻈﻧ زا ﻪﻛ روژﺎﻣ ﻲﻤﺳﻻﺎﺗ B و C و HIV ﻲﻔﻨﻣ ﺪﻨﺘﺴﻫ ، ﻳﺰﺟ تاﺮﻴﻴﻐﺗ ﺎﻬﻨﺗ ﺖﺒﺴﻧ ﻲ CD4/CD8 رد يﺎﻫ ﺖﻴﺳﻮﻔﻨﻟ T د نارود ﻦﻳا لﻮﻃ رد نارﺎﻤﻴﺑ ﻦﻳا و ﺪﻧرا يرﺎﻤﻴﺑ زا ، لﻮﻠﺳ ﻒﻴﻔﺧ تﻻﻼﺘﺧا T ﺪﻨﻫد ﻲﻣ نﺎﺸﻧ ار . يﺎﻫ لﻮﻠﺳ هوﺮﮔ ﺮﻳز ﻂﺳﻮﺘﻣ ﺶﻳاﺰﻓا CD3+ زا ﻲﺘﻧآ ﻚﻳﺮﺤﺗ هﺪﻨﻨﻛ ﺲﻜﻌﻨﻣ ًﻻﺎﻤﺘﺣا ،ﺎﻫ ﺖﻴﺳﻮﻔﻨﻟ ﺮﻴﻏ ﻚﻴﻧژ ﺎﺑ ﺪﻧاﻮﺗ ﻲﻣ هﺪﻳﺪﭘ ﻦﻳا و ﺖﺳا ﻲﺻﺎﺼﺘﺧا ﻊﻓد نﺎﻣرد و نﻮﺧ ﻖﻳرﺰﺗ ناﺰﻴﻣ ،ﻦﺳ ﻦﻴﺑ ﻲﻔﻨﻣ طﺎﺒﺗرا ﻲﻧاواﺮﻓ ﺎﺑ ﻦﻫآ يﺎﻫ لﻮﻠﺳ CD3+ هداد ﺢﻴﺿﻮﺗ دﻮﺷ . يوﺎﺣ ﻲﻧﻮﺧ يﺎﻫ هدرواﺮﻓ زا هدﺎﻔﺘﺳا ترﻮﺻ رد ﺮﺗ ناﻮﺟ ﺰﻣﺮﻗ يﺎﻫ لﻮﺒﻠﮔ ﻪﺑ زﺎﻴﻧ ﺶﻫﺎﻛ نآ ﺐﻗﺎﻌﺘﻣ و د يﺎﻫوراد ﻪﺑ زﺎﻴﻧ ﺶﻫﺎﻛ ﺰﻴﻧ و نﻮﺧ ﺎﺗ ناﻮﺗ ﻲﻣ ﻦﻫآ ﻊﻓ نارﺎﻤﻴﺑ ﻦﻳا رد ﻲﻨﻤﻳا ﻢﺘﺴﻴﺳ سردوز يﺮﻴﭘ زا يدﺎﻳز ﺪﺣ دﺮﻛ يﺮﻴﮕﺸﻴﭘ . نارﺎﻤﻴﺑ رد ﺮﺿﺎﺣ ﻪﻌﻟﺎﻄﻣ ﻪﻜﻨﻳا ﻪﺑ ﻪﺟﻮﺗ ﺎﺑ زا ﺶﻴﺑ ﻦﺳ ﺎﺑ 10 دﺎﻬﻨﺸﻴﭘ ،ﺖﺳا هﺪﺷ مﺎﺠﻧا لﺎﺳ يﺮﻴﭘ هﺪﻳﺪﭘ و تاﺮﻴﻴﻐﺗ عﻮﻧ ﻦﻳا ﻲﺳرﺮﺑ ﺖﻬﺟ ددﺮﮔ ﻲﻣ ﺘﻤﻛ ﻦﻴﻨﺳ ﺎﺑ نارﺎﻤﻴﺑ ﻲﻨﻤﻳا ،سردوز ﻲﺳرﺮﺑ درﻮﻣ ﺰﻴﻧ ﺮ ﺪﻧﺮﻴﮔ راﺮﻗ . يﺮﻴﭘ يﺎﻫ ﺺﺧﺎﺷ ﺮﻳﺎﺳ ﻲﺳرﺮﺑ ﻦﻴﻨﭽﻤﻫ ددﺮﮔ ﻲﻣ ﻪﻴﺻﻮﺗ نارﺎﻤﻴﺑ ﻦﻳا رد ﻲﻨﻤﻳا ﻢﺘﺴﻴﺳ . ﻲﻧادرﺪﻗ و ﺮﻜﺸﺗ : هﺎﮕﺸﻧاد ﻲﺸﻫوﮋﭘ ﺖﻧوﺎﻌﻣ ﻲﻟﺎﻣ ﺖﻳﺎﻤﺣ ﺎﺑ ﻪﻌﻟﺎﻄﻣ ﻦﻳا ﻲﻟﻮﻠﺳ تﺎﻘﻴﻘﺤﺗ ﺰﻛﺮﻣ رد دﺮﻛﺮﻬﺷ ﻲﻜﺷﺰﭘ مﻮﻠﻋ ﻲﻟﻮﻜﻟﻮﻣ ﺳﺎﭙﺳ ﺎﻬﻧآ زا ﻪﻠﻴﺳﻮﻨﻳﺪﺑ ﻪﻛ ﺖﺳا هﺪﺷ مﺎﺠﻧا ددﺮﮔ ﻲﻣ يراﺰﮕ . ﺖﻛﺮﺷ نارﺎﻤﻴﺑ و ﺮﺟﺎﻫ نﺎﺘﺳرﺎﻤﻴﺑ ﻲﻤﺳﻻﺎﺗ ﺶﺨﺑ زا ﻦﻴﻨﭽﻤﻫ ددﺮﮔ ﻲﻣ ﻲﻧادرﺪﻗ حﺮﻃ رد هﺪﻨﻨﻛ . ﻊﺑﺎﻨﻣ : 1. Galanello R, Origa R. Beta-thalassemia. Orphanet J Rare Dis. 2010; 5: 11.
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Cite this article as: Karimi L, Beshkar P, Shirzad H, Kheiri S, Rasti M, Nourbakhsh MK, Pourgheysari B. Frequency of T lymphocyte subsets in major beta-thalassemia patients and the influencing factors. J
Shahrekord Univ Med Sci. 2013 Oct, Nov; 15(4): 7-15.
*Corresponding author:
Cellular and Molecular Research Center, Shahrekord University of Medical Sciences, Shahrekord, I.R. Iran. Tel: 00983813336720, E-mail: bat238@yahoo.com
Frequency of T lymphocyte subsets in major beta-thalassemia patients
and the influencing factors
Karimi L (MSc student)1, Beshkar P (MSc)1, Shirzad H (PhD)1, Kheiri S (PhD)2,
Rasti M (BSc)3, Nourbakhsh MK (MD)3, Pourgheysari B (PhD)4*
1Cellular and Molecular Research Center, Shahrekord University of Medical Sciences,
Shahrekord, I.R. Iran; 2Clinical Biochemistry Research Center, Shahrekord University of
Medical Sciences, Shahrekord, I.R. Iran; 3Pediatric Dept., Shahrekord University of Medical
Sciences, Shahrekord, I.R. Iran; 4Medical Plants Research Center, Shahrekord University of
Medical Sciences, Shahrekord, I.R. Iran
Received: 18/Dec/2012 Revised: 4/Feb/2013 Accepted: 10/Feb/2013
Background and aims: Of common therapeutically methods among thalassemia patients are
repeated transfusion and iron-chelation therapy. Infectious complications are considered as serious problems among thalassemia patients, which could be derived from immunologic abnormalities. In the present study, the frequency of main subsets of T lymphocytes and CD3+ CD27+ lymphocytes and the association between these changes and age, blood transfusion rate, serum ferritin, and iron-chelation therapy were examined.
Methods: In this cross-sectional study, 27 patients (10-30 years old) with major thalassemia,
according to clinical and experimental criteria, referring to Hajar Hospital of Shahrekord in 2011 were enrolled. Control group included 26 healthy people matched with the patients by age and gender. Venous blood samples were collected in the tubes containing sodium heparin, stained with labeled monoclonal fluorescent antibodies after red cells’ lysis, and analyzed by flowcytometrically. The number of cells was calculated according to the above analysis’ results and blood cell count. The data were analyzed by SPSS using Mann-Whitney and Spearman correlation.
Results: The absolute number of lymphocytes in the patients was significantly higher than that in the
control group and the percentage of T lymphocytes was significantly lower in the patients compared to the control group (P<0.001). The number of T lymphocytes in both groups of CD4 and CD8 was not significantly different between the patients and the control group (P>0.05). The frequency of CD3+ CD7+ lymphocytes in both cell types of CD4 and CD8 was lower in the patients compared to the control group. This difference was partially significant only in CD4 subset (P=0.07). The number of CD3+CD4+CD27+ lymphocytes was inversely correlated with blood transfusion rate and desferal consumption, and the number of CD3+CD8+CD27+ lymphocytes was inversely correlated with age, blood transfusion, and desferal consumption.
Conclusion: Regarding the results, it can be concluded that the patients with major thalassemia who
are hepatitis B- and hepatitis C-negative have T cell mild disorders. The moderate increase in CD3+CD27- lymphocyte subset possibly reflects unspecific antigenic stimulation, probably explained by negative association between age, blood transfusion rate, and iron-chelation and the frequency of CD3+CD27+ cells.
