慢性丙型肝炎患者肝免疫标志物和病毒基因型研究

Correlation between hepatic immunological markers and virus genotype in patients with chronic hepatitis C

目的研究慢性丙型肝炎患者肝免疫标志物和病毒基因型的关系。方法取28例HFE基因型患者的肝活检标本进行切片染色,并通过形态测定法分析CD8,主要组织相容性复合体-Ⅰ类(majorhistocompatibilitycomplexclassⅠ,MHC-Ⅰ),β2微球蛋白(β2microglobulin,β2-mG),HFE和CD68。其中18例患者的治疗应答性资料有效。结果CD8+常聚集于肝汇管区和窦状隙,CD8+与MHC-Ⅰ阳性内样细胞相互作用。MHC-Ⅰ和β2-mG主要表达于内皮细胞和枯否细胞,而大多数HFE表达于圆形和树突状CD68+细胞。基因型为3a的丙型肝炎患者肝MHC-Ⅰ和HFE强表达,且对干扰素治疗持续应答率较高。结论慢性丙型肝炎患者MHC-Ⅰ的肝脏表达可能与病毒基因型相关。HCV3a基因型上调MHC-Ⅰ和HFE的表达。

Objective To investigate the hepatic expression of immunological markers relevant to a eytotoxic response in relation to viral genotype. Methods The frozen liver biopsies were obtained from 28 HFE genotyped patients and made the sections stained. The morphometry was used to analyze the major histocompatibility complex class Ⅰ（MHC- Ⅰ）, CD8^＋β2-mieroglobulin （β2- mG）, HFE and CD68 in the stained sections. Biopsy data of response to therapy with interferon were available in 18 eases. Results CD8 ^＋ was usually clustered together and localized in portal tracts and sinusoids, and seen to interact with MHC- Ⅰ positive lining cells. MHC- Ⅰand β2- mG were expressed mainly in endothelial and Kupffer cells, lIFE was expressed in most round and dendritic CD68 ccells. Patients with virus genotype 3a had higher hepatic MHC- Ⅰand HFE expression, and a better sustained response to interferon （IFN） therapy than patients without. Conclusion The MHC- Ⅰ expression in the liver of patient with chronic hepatitis C virus infection seems to relate to viral-genotype. The hepatic MHC-Ⅰ and HFE expression are higher in patients with virus genotype 3a than that in patients with non-3a genotype.