髓源性抑制细胞在慢性乙型肝炎急性发作患者外周血中的表达

Expression and role of myeloid-derived suppressor cells in patients with acute exacerbation of chronic hepatitis B

目的研究髓源性抑制细胞(MDSC)在慢性乙型肝炎急性发作(AECHB)患者外周血中的表达。方法分选取2016年1月至2017年1月于广州市第八人民医院住院治疗的慢性乙型肝炎急性发作患者40例,以及门诊就诊的免疫耐受期慢性乙型肝炎病毒感染者40例和同期体检正常的健康对照组40例。采用流式细胞术检测外周血MDSC的频率。分析MDSC表达频率在各组中的差异及其与各临床指标的关系。结果 AECHB组MDSC频率均值为(0.32±0.18),低于ITCHB组的(0.61±0.26),差异有统计学意义(P<0.001);与健康对照组的(0.35±0.20)比较,则差异无统计学意义(P=0.48)。MDSC频率与谷丙转氨酶(ALT),谷草转氨酶(AST)呈负相关(r=-0.45、-0.48,P<0.01);与胆红素水平、凝血酶原活动度、HBV DNA水平无相关性(P>0.05)。结论 MDSC可能与慢性乙型肝炎感染后免疫耐受及肝炎活动相关。

Objective To investigate the role of myeloid- derived suppressor cells （MDSC） in patients with acute exacerbation of chronic hepatitis B. Methods 40 patients with acute exacerbation of chronic hepatitis B, 40 patients with immune tolerant chronic hepatitis B and 40 healthy controls were enrolled in the study. The frequency of MDSCs was detected by flow cytometry. And its relationships with various clinical indexes were analyzed. Results The frequency of MDSC in patients with acute exacerbation of chronic hepatitis B was lower than that of patients with immune tolerance chronic hepatitis B [ （0.32±0.18） vs. （0.61±0.26）, P〈0.001 ], compared with healthy control group, the difference was not statistically significant [ （0.32±0.18） vs. （0.35±0.20） , P=0.48]. The frequency of MDSC and alanine aminotransferase （ALT） and aspartate aminotransferase （AST） were negatively correlated （r=-0.45,-0.48, P〈0.01）. There was no correlation with bilirubin level, prothrombin activity, and HBV DNA level （P〉0.05）. Conclusion The frequency of MDSC in patients with chronic hepatitis B decreased when acute exacerbation occur, which implied that MDSC could be related to the immunotolerance and inflammation of chronic hepatitis B.