慢性乙型肝炎的疫苗治疗免疫学机制的探讨

effect of the therapeutic vaccination in patients with chromic hepatitis B

通过对乙型肝炎疫苗治疗的13例患者的观察,分析乙型肝炎表面抗原特异细胞增殖反应及其抗原特异性T细胞分泌的细胞因子水平,以及观察疫苗治疗后的临床效果,探讨肝炎疫苗治疗慢性乙型肝炎的免疫学作用机制。血清HBVDNA水平在疫苗治疗结束后6个月显著地下降。疫苗治疗诱生6例抗原特异性CD4 + T细胞的增殖反应(38 5 % ) ,同时分泌高水平的干扰素-γ和肿瘤坏死因子-α。血清HBVDNA水平在疫苗治疗结束6个月和18个月显著下降。表面抗原特异性CD4 + T细胞可以间接地抑制HBV的复制。

Vaccinated 13 patients were analyzed for T cell proliferative responses specific for surface antigen and cytokine production by antigen-specific T cells.Serum H BV DNA levels decreased significantly at 6 months after completion of therapy an d thereafter as compared to the baseline ones.Vacccination induced antigen-speci fic CD4+T cell proliferative responses in 6 patients(38.5%).The production of high levels of interferon-γ and tumor necrosis factor-α by antigen-specific T cells was found in 6 patients who showed significantly lower HBV DNA levels in serum at 6 and 18 months after completion of therapy than those without high lev els of cytokine production.Envelope-specific CD4+T cells indirectly control HB V replication by producing antiviral cytokines in the therapeutic vaccination ag ainst chronic HBV infection.