不同类型慢性乙型肝炎病毒感染者效应性与调节性T细胞相关因子的表达及其临床意义

Expression and clinical significance of effect and regulatory T cell-associated cytokines in patients with different types of chronic HBV infection

目的探讨效应性与调节性CD4+T细胞相关细胞因子介导的免疫平衡在慢性乙型肝炎(CHB)发病中的作用及其临床意义。方法收集慢性乙型肝炎病毒(HBV)感染者74例,其中CHB患者27例,慢性HBV携带者(ASC)23例,肝炎肝硬化(LC)患者24例,应用ELISA方法,检测其外周血血浆中效应性及调节性细胞因子的表达水平,结合临床指标进行分析。结果与正常对照组和ASC组比较,CHB和LC组患者IFN-γ和TGF-β1的表达水平明显升高,差异有统计学意义(F=10.58,P=0.000;F=5.34,P=0.002);与正常对照组比较,CHB、ASC和LC组患者IL-10的表达差异有统计学意义(F=11.95,P=0.000);而IL-17在各组之间差异无统计学意义。ALT和HBV DNA与IFN-γ、TGF-β1、IL-10及IL-17的表达水平均无相关性;ALT与TGF-β1/IL-17具有明显相关性(r=0.435,P=0.023)。结论不同类型慢性HBV感染者存在着明显的免疫调节功能紊乱,且与肝内炎症的发生和疾病进展密切相关。

Objective To investigate the role and clinical significance of the effect and regulation of CD4+T cell cytokine mediated immune balance in pathogenesis with chronic hepatitis B.Methods 74 patients with chronic HBV infection were collected,included 27 patients with chronic hepatitis B(CHB),23 cases with chronic HBV carriers(ASC) and 24 patients with liver cirrhosis(LC).The expression levels of related cytokines in different types of chronic HBV infection were detected by ELISA and analysed with clinical indicators.Results Compared with normal control and ASC group,the level of IFN-γ and TGF-β1 were significantly increased in patients with CHB and LC group(F=10.58,P=0.000;F=5.34,P=0.002).The level of IL-10 was significantly elevated in patients with CHB,ASC and LC compared with normal controls(F=11.95,P=0.000).No significant differences were found at the IL-17 between each groups.No correlation was found between the ALT,HBV DNA and a single cytokine expression.A significant correlation was found between the ALT and TGF-β1/IL-17(r=0.435,P=0.023).Conclusions There are obvious immune dysfunction in different types of chronic HBV infection,and closely associated with liver inflammation and disease progression.