HBV感染的CD68细胞在隐匿性HBV感染产妇胎盘中的分布及与宫内感染的关系

The relationship between distribution of HBV infected CD68 cell in occult HBV infected placenta and intrauterine transmission

目的探讨HBV感染的外周血单个核细胞(peripheral blood mononuclear cells,PBMC)在乙肝宫内传播中的作用及机理。方法12例血清HBV DNA(-)、PBMC HBV DNA(+)产妇分娩的新生儿血清HBV DNA(+)和/或PBMC HBV DNA(+)的胎盘作为实验组,10例乙肝标志物均为阴性产妇的胎盘作为对照。采用SP法在连续切片上检测HBsAg和HBcAg在胎盘CD68细胞及各类细胞中的表达。结果8例新生儿血清HBV DNA(-)、PBMCsHBV DNA(+)胎盘绒毛间质5例CD68细胞HBsAg阳性,6例CD68细胞HBcAg阳性;毛细血管内5例CD68细胞HBsAg阳性,8例CD68细胞HBcAg阳性;滋养层细胞和血管内皮细胞均未见HBsAg、HBcAg阳性信号;2例新生儿血清HBV DNA(+)、PBMCs HBV DNA(-)的胎盘滋养层细胞、绒毛间质、毛细血管内皮细胞均有HBsAg、HBcAg的表达,而绒毛毛细血管内CD68细胞未见表达。2例新生儿血清和PBMC HBV DNA均阳性的的胎盘滋养层细胞、绒毛间质、CD68细胞和毛细血管内CD68细胞均有HBsAg、HBcAg的表达,毛细血管内皮细胞无表达。10例乙肝标志物全阴性产妇胎盘中均无阳性信号。结论HBV感染的外周血单个核细胞可作为宫内传播的载体。

Objective：To investigate the function of peripheral blood mononuclear cells （PBM）in HBV intrauterine transmission. Methods：The placenta of 12 pregnant women with serum HBV DNA negative,PBMC HBV DNA positive and their newborns with PBMC HBV DNA positive and /or serum HBV DNA positive were as study group. The placenta of 10 pregnant women with HBV markers negative served as the control group. HBsAg and HBcAg in cells of placenta and CD68 were detected by immunocytochemical. Results：It was shown that the positive signal of HBsAg and HBcAg can be detected in CD68 of villous mesenchymal and within villous capillary in placenta of 8 newborns with PBMC HBVDNA positive. In placenta of 2 newborn with serum HBV DNA positive,HBsAg and HBcAg positive signal can be detected in trophoblastic cells,villous mesenchymal cells and villous capillary endothelial cells. Further more,in placenta of 2 neonate with both serum and PBMC HBV DNA positive,HBsAg and HBcAg positive signal can be detected in trophoblastic cells,villous mesenchymal,CD68 and CD68 whithin villous capillary. There was no positive signal in placenta of control group. Conclusions：HBV-infected PBMC of mother can serve as a vector,which may directly pass placenta or first infect placenta,then infect fetus.