CD4^+ CD25^+ Foxp3^+ Treg细胞在HBV感染所致慢加急性肝衰竭中作用

Effect of CD4^+ CD25^+ Foxp3^+ regulatory T cells on acute-on-chronic liver failure caused by hepatitis B infection

目的:探讨CD4+CD25+Foxp3+Treg细胞在HBV感染所致慢加急性肝衰竭发病过程中的表达。方法:采用流式细胞仪检测36例慢加急性肝衰竭患者、38例慢性乙型肝炎患者、40例无症状乙肝病毒携带者及40例健康对照者外周血CD4+CD25+Foxp3+Treg细胞水平,并追踪慢加急性肝衰竭组患者转归,评价好转组与未恢复组CD4+CD25+Foxp3+Treg细胞百分率差异。结果:慢加急性肝衰竭组、慢性乙型肝炎组、无症状乙肝病毒携带组及健康对照组外周血CD4+CD25+Foxp3+Treg细胞分别为(5.14±1.03)%、(9.86±1.72)%、(7.93±1.67)%及(7.06±1.61)%,慢加急肝衰竭组外周血Treg细胞百分率显著低于慢性乙型肝炎组、无症状乙肝病毒携带组和健康对照组(P<0.01)。慢性乙型肝炎组外周血Treg百分率明显高于慢加急肝衰竭组及健康对照组,差异有统计学意义(P<0.05),而无症状乙肝病毒携带组与健康对照组外周血Treg百分率比较差异无统计学意义(P>0.05)。各组CD4+CD25+Foxp3+Treg细胞的百分率与患者血清HBVDNA呈正相关。慢加急性肝衰竭好转组与未恢复组CD4+CD25+Foxp3+Treg细胞水平比较,差异无统计学意义(P>0.05)。结论:慢加急性肝衰竭患者发病可能与CD4+CD25+Foxp3+Treg细胞表达过低有关,Treg细胞表达水平不能预示慢加急性肝衰竭患者预后。

Objective： To explore the effect of CD4^＋CD25^＋ Foxp^3＋ regulatory T cells on acute-on-chronic liver failure（ACLF） caused by hepatieis B infection. Methods： CD4^＋ CD25^＋ Foxp^3＋ regulatory T cells level was detec- ted in peripheral blood of 36 patients with ACLF （ACLF group）, 38 patients with chronic hepatitis B （CAH group）, 40 cases of asymptomatic carriers （ ASC group） and 40 healthy people （ control group） by flow cytometry method. The percentage of CD4^＋ CD25^＋ Foxp^3＋ regulatory T cells in non recovery group was compared with im- proved group of ACLF patients. Results： The expression levels of CD4^＋CD25^＋ Foxp^3＋ regulatory T cells in pe- ripheral blood of ACLF group, CAH group, ASC group and control group were （5. 14 _＋ 1.03） % , （9.86 _＋ 1.72） %, （7.93 -＋ 1.67） %, （7.06 -＋ 1.61 ） % respectively. The percentage of regulatory T cells of ACLF group was significantly lower than that of CAH group, ASC group and control group （P 〈0.01 ）. The percentage of pe- ripheral blood regulatory T cells of CAH group was higher than that in ASC group and control group （ P 〈 0.05 ）. The percentage of peripheral blood regulatory T cells of ASC group and the control group was no significant different （P 〉 0.05）. The percentage of CD4^＋ CD25^＋ Foxp^3＋ regulatory T cells in study group was positively correlated with serum HBVDNA. Levels of CD4^＋ CD25^＋ Foxp^3＋regulatory T cells showed no significant difference between non recovery group and improved group of ACLF patients （ P 〉 0.05 ）. Conclusion ： The incidence of ACLF may be related with the low expression level of CD4^＋ CD25^＋ Foxp^3＋ regulatory T cells. The level of regulatory T cells couldn＇t indicate the prognosis of ACLF patients.