扶正与祛邪法对HBV慢性感染患者外周血DCs介导的T淋巴细胞的影响

Effects of Fuzheng and Quxie methods on T lymphocides mediated by peripheral blood DCs from patients with chronic HBV infection

目的比较健脾法、补肾法与解毒法对慢性乙肝病毒(HBV)感染患者外周血树突状细胞DCs介导的T淋巴细胞的影响。方法分别收集10例HBV慢性感染免疫耐受期、免疫清除期患者和8例健康人的抗凝外周血,分离外周血单个核细胞(PBMCs),体外培养DCs,用大鼠健脾、补肾、解毒药物血浆进行干预,并建立DCs、T细胞相互作用的模型,检测T细胞的表面分子CD8+CD28+、CD8+PD-1受体的表达。结果经补肾药物血浆(六味地黄丸)、健脾药物血浆(四君子汤)、解毒药物血浆(甘露消毒丹)处理,HBcAg负载的DCs孵育的T淋巴细胞,CD8+CD28+表达率升高,CD8+PD-1受体表达率降低。结论补肾、健脾、解毒法在一定程度上都能通过恢复慢性HBV感染免疫清除期、免疫耐受期患者外周血DCs的功能,以恢复其下游的T淋巴细胞的功能。相比而言,补肾法最优,健脾法次之,再次是解毒法。

[Abstract~ Objective To compare the effects of TCM treatment methods including Jianpi （Si- junzi decoction）, Bushen （Liuwei Dihuang decoction） and Jiedu （Ganlu Xiaodu decoction） on T lym- phocytes mediated peripheral blood DCs from persons with chronic hepatitis B virus（HBV） infection. Methods 10 patients in immune tolerance stage and 10 patients in immune clearance stage with chronic HBV infection and 8 healthy persons were included in this study. DCs were differentiated from PBMCs which were isolated from persons＇ peripheral blood, incubated and then induced. The DCs were interfered by plasma containing Liuwei Dihuang decoction, Sijunz- i decoction and Ganlu Xiaodu decoction, respetively. The model of the interaction between DCs and T cells was established and the expressions of CD8~CD28~, CDS^PD-~ were detected by FACS. Re- sults The rate of CD8~CD28~ of T lymphocyte was increased whle the rate of CDS^PD-1 of T lym- phocyte was reduced after incubated by DCs, which were interfered by plasma containing with Liuwei Dihuang decoction, Sijunzi decoction and Ganlu Xiaodu decoction ,respectively, and loaded by HbcAg. Conclusion To a certain extent, TCM treatment methods including invigorating spleen（Sijunzi decoction）, tonifying kidney（Liuwei Dihuang decoction） and detoxification（Ganlu Xiao- du decoction） can restore the function of peripheral blood DCs of the immune clearance phase and the immune tolerance chronic HBV infection patients and then restore T lymphocyte function in its downstream. In contrast, the optimal method is tonifying Kidney, the next is nvigorating spleen and finally it is detoxification.