慢性HBV感染患者外周血MAIT细胞表达水平及临床意义探讨

The expression of MAIT cells in peripheral blood of patients with chronic HBV infection and its clinical significance

目的探讨乙型肝炎病毒(hepatitis B virus,HBV)感染患者不同临床阶段外周血中黏膜相关恒定T细胞(mucosal-associated invariant T,MAIT)的表达情况及其在乙肝疾病进程中的临床意义。方法收集安徽医科大学第二附属医院2021年10月至2022年12月的55例HBV感染患者作为实验组,其中55例HBV感染患者包括慢性乙型肝炎患者20例,乙肝肝硬化患者20例,乙肝肝癌患者15例;选取同期34名健康志愿者作为对照组。采用流式细胞仪对所有研究对象外周血中MAIT细胞频率及分泌干扰素-γ(interferon-γ,INF-γ),颗粒酶B(granzyme B,GrB)水平进行检测,统计分析慢性HBV感染患者外周血MAIT细胞频率与肝功能、HBV-DNA的相关性。结果慢性乙型肝炎患者、乙肝肝硬化患者及肝癌患者外周血中MAIT细胞频率均低于健康对照组[%:(2.24±1.03),(1.86±1.33),(1.63±1.45)比(3.73±2.03),P值均<0.05]。慢性HBV患者、乙肝肝硬化失代偿期患者以及肝细胞癌患者之间MAIT细胞频率差异无统计学意义(P>0.05)。MAIT细胞频率与HBV-DNA水平无明显相关性,但与总胆红素(total bilirubin,TBIL)水平呈负相关相关性(r=-0.409,P<0.05)。HBV-DNA+与HBV-DNA-患者MAIT细胞分泌IFN-γ能力较健康对照组显著下降[%:(26.44±6.17),(26.24±9.54)比(45.85±16.93),P值均<0.05],与HBV-DNA水平无关(P>0.05)。结论慢性HBV感染患者外周血中MAIT细胞频率及功能发生变化,与肝脏损伤有关。通过靶向MAIT细胞的调控,可能为慢性HBV感染患者的临床诊治提供新思路。

Objective To investigate the expression of mucosal-associated invariant T(MAIT)cells in peripheral blood of patients with hepatitis B virus(HBV)infection at different clinical stages and its clinical significance in the process of chronic hepatitis B disease.Methods The frequency of MAIT cells in peripheral blood and the release of interferon-γ(IFN-γ),granzyme B(GrB)were measured by flow cytometry in 55 patients with HBV infection and 34 healthy controls in the second Affiliated Hospital of Anhui Medical University from October 2021 to December 2022.In the 55 patients,20 patients with chronic hepatitis B,20 patients with hepatitis B cirrhosis,and 15 patients with hepatitis B liver cancer.The correlation between MAIT cell frequency with chronic HBV infection and age,sex,liver function,and HBV-DNA level was statistically analyzed.Results The frequency of MAIT cells including chronic hepatitis B,hepatitis B cirrhosis and hepatitis B liver cancer was lower than that of healthy controls[%:(2.24±1.03),(1.86±1.33),(1.63±1.45)vs(3.73±2.03),all P values<0.05].MAIT cell frequency has significant negative correlation with total bilirubin level(r=-0.409,P<0.05)and no correlation with HBV-DNA(P>0.05).The level of IFN-γwas reduced in patients with HBV-DNA+and HBV-DNA-compared to healthy controls[%:(26.44±6.17),(26.24±9.54)vs(45.85±16.93),all P values<0.05],which is independent of the level of HBV-DNA(P>0.05).Conclusion The frequency and function of MAIT cells were abnormal in peripheral blood of patients with chronic hepatitis B virus infection,which may be related to liver injury and provide reference value for clinical diagnosis and treatment in patients with chronic HBV infection.