乙型肝炎相关性肝衰竭阴、阳黄证患者外周血DCs功能比较研究

Comparison on Dendritic Cells Function of Yang-Huang and Yin-Huang Syndrome in HBV Related Hepatic Failure Patients

目的:比较乙型肝炎(HBV)相关性肝衰竭阴黄证、阳黄证患者外周血树突状细胞(DCs)功能,研究阴黄证、阳黄证两证型DCs的免疫表达特点。方法:将HBV相关性肝衰竭黄疸症患者分为阳黄组与阴黄组两组,另设健康对照组,以外周血来源的PBMCs体外分离诱导培养DCs,应用流式细胞计数检测DCs的表面分子HLA-DR、CD80、CD86、CD83、CD1α,并检测DCs的上清液中IFN-α、IL-4的分泌水平,比较HBV相关性肝衰竭患者阴、阳黄证与免疫细胞及炎症因子表达的差异。结果:与健康组比较,HBV相关性肝衰竭患者DCs表型HLA-DR、CD1α、CD83、CD80、CD86表达率显著下降(P<0.01),DCs分泌因子IFN-α显著升高(P<0.01);与阳黄组比较,HBV相关性肝衰竭患者阴黄组CD83、CD86表达率显著降低(P<0.01),IL-4表达显著增强(P<0.01);与阴黄组比较,阳黄证组DCs分泌因子IFN-α表达显著增强(P<0.01)。结论:阴黄、阳黄两组HBV相关性肝衰竭患者的DCs功能状态均表现为细胞免疫功能低下,阴黄证患者的细胞免疫功能更低,存在抗炎症细胞因子表达增强;阳黄证患者存在炎症因子过度释放。

This study was aimed to compare the function of dendritic cells （DCs） in patients of Yin-Huang syn- drome and Yang-Huang syndrome from the peripheral blood of HBV related hepatic failure. Jaundice patients of HBV related hepatic failure were divided into two groups, which were the Yang-Huang syndrome group and Yin- Huong syndrome group. And a healthy control group was also established. The DCs were separated and cultured in vitro from PBMCs in the peripheral blood. Surface molecules such as HLA-DR, CD80, CD86, CD83 and CD1α were detected by the flow cytometry. And the level of IFN- α and IL-4 in the supernatant of DCs were also detected. The expression difference of inflammatory cytokines and immune cells between Yin-Huang and Yang- Huang syndrome in patients of HBV related hepatic failure were compared. The results showed that compared with healthy people, the expression rate of DCs phenotype such as HLA-DR, CD1α, CD83, CD80, CD86 in patients of HBV related hepatic failure was significantly decreased （P 〈 0.01）; the excreted factor IFN-α had a significant rising （P 〈 0.01）. Compared to Yang-Huang syndrome group, the expression rate of CD83 and CD86 in the Yin- Huang syndrome group of HBV related hepatic failure patients was significantly reduced （P 〈 0.01）. And the excreted factor of IL-4 had a significant rising in Yin-Huang syndrome group （P 〈 0.01）. Compared to the Yin- Huang syndrome group, the excreted factor IFN-α in the Yang-Huang syndrome group had a significant rising （P 〈 0.01）. It was concluded that DCs function of patients with HBV related hepatic failure in both Yin-Huang syn- drome and Yang-Huang syndrome group showed low immune function. And the immune function of the Yin- Huang syndrome group was lower. There was excessive releasing of inflammatory factors in the Yang-Huang syn- drome group. And there was enhanced anti-inflammatory cytokine expression in the Yin-Huang group.