Th17细胞与Treg细胞在HBV感染患者中的检测意义

Changes and Significance of peripheral Th17 cells and Treg cells in HBV infected patients

目的了解HBV感染后肝细胞不同程度损伤的患者外周血中辅助性T细胞17(Th17)和调节性T细胞(Treg)的比例变化。方法选取乙型肝炎患者109例,其中无症状HBV携带者32例(ASC组)、慢性乙型肝炎47例(CHB组)、肝细胞癌伴活动性肝炎30例(HCC组)。另选健康体检者25名作为对照组。采用流式细胞术检测外周血Th17细胞和Treg细胞以及CD3+、CD3+CD4+T细胞含量,自动生化分析仪检测血清ALT、AST。结果与对照组Treg细胞比较,ASC组稍高,但差异无统计学意义(t=0.809,P>0.05);CHB组、HCC组升高明显(t=2.988、7.569,P<0.05),均高于ASC组(t=2.456、7.177,P<0.05);HCC组患者外周血Treg细胞比例高于CHB组,差异有统计学意义(t=4.057,P<0.05);外周血Treg细胞比例与血清ALT和AST水平呈正相关(r=0.546、0.587,P<0.01)。与对照组Th17细胞比较,ASC组略有升高,但差异无统计学意义(t=1.459,P>0.05);CHB组和HCC组均明显升高(t=3.910、6.725,P<0.05),且HCC组高于CHB组(t=6.580,P<0.01);外周血Th17细胞比例与血清ALT和AST水平呈正相关(r=0.546、0.617,P<0.01)。在Th17/Treg比值上,外周血Th17细胞和Treg细胞在HBV感染者中呈正相关(r=0.487,P<0.05),对照组Th17/Treg比值最低(0.15%±0.14%),CHB组、HCC组升高明显(t=2.015、5.056,P<0.05),Th17升高更为明显。结论随着HBV感染患者病情的发展,外周血Th17/Treg细胞比例升高,Th17、Treg细胞构成免疫的平衡状态被破坏,机体受到Th17细胞介导的炎性反应,造成肝细胞损伤。

Objective To investigate the changes of T helper 17 （Th17）cells and regulatory T （Treg）cells in the peripheral blood of hepatitis B virus（HBV）infected patients and their correlations with liver injury.Methods One hundred and nine cases of hepatitis B patients were chosen in our hospital from March 2010 to January 2013 and were divided into four groups in accordance with the condition of diseases.The peripheral blood of 32 asymptomatic HBV carriers （ASC group）,47 chronic hepatitis B patients （CHB group）,30 hepatocellular carcinoma patients （HCC group）and 30 healthy controls （control group）were collected.The percentages of Th17 and Treg cells were detected by flow cytometry.Alanine aminotransferase （ALT）and aspartate aminotransferase （AST）were detected by automatic biochemistry analyzer.Results Compared with control group,the percentages of both Treg and Th17 cells in the peripheral blood of ASC group were higher,but no statistical difference was detected （t =0.809,P 〉0.05 for Treg cells;t =1 .459,P 〉0.05 for Th17 cells, respectively）.While significant increase of percentages of Treg cells and Th17 cells in CHB group and HCC group was found（t=2.988,7.569,P 〈0.05 for Treg cells;t=3.910,6.725,P 〈0.05 for Th17 cells,respectively）.And Treg cells increase in HCC group was higher than that in CHB group （t=6.580,P 〈0.01）.Treg cells and Th17 cells were correlated positively with ALT and AST（r=0.546,0.587,P 〈0.01 for Treg cells;r =0.546、0.617,P 〈0.01 for Th17 cells）,and Th17 cell percentage was positively correlated with Treg cell percentage （r =0.487,P 〈0.01）.The rate of Th17/Treg in control group was the lowest （0.15%±0.14%）,while significantly higher Th17/Treg ratio in CHB group and HCC group were observed （t=2.015,5.056,P 〈0.05）.Conclusion With the development of HBV infection,the percentages of Th17 and Treg cells increased.The destruetion of the immune balance leads to the increased of Th17 cells that induced immune injury and induce the inflammation of liver cells.