Th1/Th2、Treg/Th17细胞平衡在慢性乙型肝炎发病机制中的作用

Effect of Th1/Th2,Treg/Th17 cell balance in the pathogenesis of chronic hepatitis B

目的分析慢性乙型肝炎(CHB)患者外周血中Th1/Th2、Th17/Treg细胞平衡及相关细胞因子水平变化,探讨其在CHB发病中的作用。方法收集64例CHB患者为CHB组,66例健康体检者为正常对照组(NC组)。采用流式细胞术检测外周静脉血中Th1、Th2、Th17、Treg细胞比例,酶联免疫法(ELISA)检测白细胞介素17(IL-17)、白细胞介素23(IL-23)、转化生长因子β1(TGF-β1)、白细胞介素4(IL-4)、干扰素γ(INF-γ)、白细胞介素10(IL-10)表达水平,比较两组丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)水平。结果 CHB组ALT、AST高于NC组(P <0.05)。CHB组Th1比例、Th1/Th2高于NC组,Th2比例低于NC组(P <0.05);CHB组Th17比例高于NC组,Treg比例及Treg/Th17低于NC组(P <0.05)。与NC组相比,CHB组IL-4、IL-10浓度降低(P <0.05),IL-17、IL-23、TGF-β1、INF-γ浓度增高(P <0.05)。结论 CHB患者血中Th1/Th2比例升高、Treg/Th17比例降低,相关细胞因子表达变化可能参与CHB的炎症和免疫应答过程。

Objective To investigate the change of Th1/Th2,Th17/Treg cell balance and cytokines in peripheral blood of patients with chronic hepatitis B(CHB),and demonstrate the role of it in the pathogenesis of CHB.Methods Sixty-four CHB patients were enrolled in group CHB,and 66 healthy subjects were enrolled in the control group(group NC).Levels of Th1,Th2,Th17 and Treg cells were detected by flow cytometry.Levels of IL-17,IL-23,TGF-β1,IL-4,INF-γand IL-10 were detected by enzyme-linked immunosorbent assay.Levels of ALT and AST were compared between the two groups.Results Levels of ALT and AST in group CHB were signifi-cantly higher than those in group NC(P<0.05,respectively).The proportion of Th1 cells and Th1/Th2 in group CHB were significantly higher than those in group NC,while the proportion of Th2 cells in group CHB was signifi-cantly lower than that in group NC(P<0.05).The proportion of Th17 cells in group CHB was significantly higher than that in Group NC.Treg cells ratio and Treg/Th17 in group CHB were significantly lower than those in group NC(P<0.05,respectively).Compared with group NC,levels of IL-4 and IL-10 were significantly decreased in group CHB(P<0.05).While,IL-17,IL-23,TGF-β1 and INF-γin peripheral blood of group CHB were signifi-cantly lower than those in group NC(P<0.05,respectively).Conclusion The increased ratio of Th1/Th2 of CHB patients and the decrease of Treg/Th17 ratio and the related cytokines may be involved in the inflammation and immune responses in CHB patients.