Treg细胞对不同阶段慢性HBV感染者长期免疫耐受状态影响分析

Effects of Treg cells on the long-term immune tolerance in patients with chronic HBV infection at different stages

目的分析调节性T细胞(Regulatory T cells,Treg)对不同阶段慢性乙型肝炎病毒(Hepatitis B virus,HBV)感染者长期免疫耐受状态影响。方法选取2016年3月-2017年3月于医院接受治疗的120例慢性HBV感染患者为研究对象,依据患者感染的自然史分期准则将其分成非活动期组、免疫清除期组和免疫耐受期组,选取同期于医院体检健康者50例为对照组;观察四组研究对象的临床指标和肝组织内Treg细胞含量情况。结果四组研究对象在肝受损、血清谷丙转氨酶(Alanine aminotransferase,ALT)、乙肝表面抗原(Hepatitis B surface antigen,HBsAg)含量、纤维程度和炎症活动度方面对比差异均有统计学意义(P<0.05);对照组Treg含量为(1.15±0.19)cells/hpf,免疫耐受期组为(2.39±0.53)cells/hpf,非活动期组为(3.28±0.97)cells/hpf,免疫清除期组为(13.86±4.25)cells/hpf,免疫耐受期组和非活动期组略高于对照组,但差异无统计学意义,免疫清除期组高于其他三组(P<0.05);不同纤维化、炎症程度患者其Treg含量比较差异有统计学意义(P<0.05),且随着纤维化和炎症程度升高含量逐渐上升。结论慢性HBV患者肝组织内大量聚集的Treg细胞并不能造成其长期免疫耐受状况,免疫清除患者机体内Treg高含量可对免疫反应产生抑制来保护宿主。

OBJECTIVE To analyze the influence of Treg cells on the long-term immune tolerance of patients with chronic HBV infection at different stages.METHODS A total of 120 patients with chronic HBV infection treated in our hospital from Mar.2016 to Mar.2017 were selected and divided into inactive period group,immune clearance period group and immune tolerance period group according to the natural history staging criteria of patients＇ infection.A total of 50 healthy persons of physical examination in the same period were selected as control group.The clinical indicators and liver Treg cell content of the four groups were observed.RESULTS The differences of liver damage,serum alanine aminotransferase（ALT）,Hepatitis B surface antigen（HBsAg）content,fiber degree and inflammatory activity were in each group（P〈0.05）.The Treg content in the control group was（1.15±0.19）cells/hpf,in the immune tolerance period group was（2.39±0.53）cells/hpf,in the inactive period group was（3.28±0.97）cells/hpf,and in the immune clearance period group was（13.86±4.25）cells/hpf.The immune tolerance period group and the inactive period group were slightly higher than those of the control group,but the difference was not statistically significant.The immune clearance period group was significantly higher than the other three groups（P〈0.05）.Patients with different degrees of fibrosis and inflammation had significant difference in the content of Treg（P〈0.05）,and with the increase of the degree of inflammation,fibrosis content gradually increased.CONCLUSIONA large number of Treg cells accumulated in the liver of patients with chronic HBV infection do not cause long-term immune tolerance.High levels of Treg in the immune-cleared patients may protect the host against the immune response.