Th17与Treg细胞免疫失衡在慢性乙型病毒性肝炎发病过程中的调节作用

The Role of Immunoregulation by Th17 and Treg Cells in the Pathogenesis of Chronic HBV Infection

目的:研究Th17/Treg细胞免疫失衡在慢性乙型病毒性肝炎不同阶段的作用.方法:选取重庆医科大学附属第二医院感染科慢性乙肝患者65例,其中包括7例无症状携带者(AsC),38例慢性乙肝轻、中度患者(CHB-LM),20例慢性重型肝炎患者(CSHB).另有10例健康对照者(HC).用流式细胞术检测外周血中Th17与Treg细胞的频数,并用ELISA方法检测相关细胞因子IL-17,IL-1β,IL-6,IL-21和TGF-β的水平.结果:Th17细胞在CSHB组中的频数明显增加,Treg细胞在AsC组中的比例最高,Th17细胞与Treg细胞之间存在负相关,相关细胞因子(IL-1β,IL-6和IL-21)在CSHB组中的表达均增加,TGF-β因子在各组中无明显变化.结论:Th17与Treg细胞在慢性乙型病毒性肝炎不同疾病阶段存在免疫失衡.在免疫耐受阶段(AsC),Treg细胞发挥主要作用,而在严重炎症活动阶段,Th17细胞发挥主要作用.

Objective： The aim of the present study was to research the effects of Th17/Treg imbalance in patients with chronic HBV infection in varying degrees. Methods： The study involved 65 patients treated at the second Affiliated Hospital of Chongqing Medical University, including 7 with asymptomatic HBV carriers （AsC）, 38 with chronic hepatitis B in low or moderate grade （CHB-LM）, 20 with Chronic Severe Hepatitis B （CSHB）, and 10 healthy subjects as controls （HC）. We examined the frequency of peripheral blood Th17 cells and Treg cells by flow cytometry, related-cytokines levels measured by Enzyme-linked immunosorbent assay （ELISA）. Results： The frequency of Th17 cells is obviously increase in CSHB group, and the frequency of Treg cells of AsC group is highest, the propotion of Thl7 cells and Treg cells is negatively correlated. The related cytokines concentration （IL-113, IL-6 an IL-21） are all increase in CSHB group, but there were no significant difference in plasma TGF-13among groups. Conclusions. Th17 and Treg cells have immune imbalance in different disease stages of chronic hepatitis B. In the immune tolerance phase. Treg cells have the major role, and in inflammatory phase of activity, Th17 cells play the important role.