AIM: To study the association between host immunity and hepatitis B virus (HBV) recurrence after liver transplantation.METHODS: Peripheral blood mononuclear cells (PBMC) were isolated from 40 patients with hepatitis B...AIM: To study the association between host immunity and hepatitis B virus (HBV) recurrence after liver transplantation.METHODS: Peripheral blood mononuclear cells (PBMC) were isolated from 40 patients with hepatitis B and underwent orthotopic liver transplantation (OLT) before and 2, 4, 8 wk after surgery. After being cultured in vitro for 72 h, the levels of INF-γ and TNF-α in culture supernatants were detected with ELISA. At the same time, the quantities of HBV DNA in serum and PBMCs were measured by real time PCR.RESULTS: The levels of INF-γ and TNF-α in PBMC culture supernatants decreased before and 2, 4 wk after surgery in turns (INF-γ 155.52±72.32 ng/L vs14.76±9.88 ng/L vs 13.22±10.35 ng/L, F= 6.946, P = 0.027<0.05; TNF-α80.839±46.75 ng/L vs 18.59±17.29 ng/L vs9.758±7.96 ng/L,F= 22.61, P= 0.0001<0.05). The levels of INF-γ and TNF-α were higher in groups with phytohemagglutinin (PHA) than in those without PHA before surgery. However,the difference disappeared following OLT. Furthermore,INF-γ and TNF-α could not be detected in most patients at wk 4 and none at wk 8 after OLT. The HBV detection rate and virus load in PBMlC before and 2, 4 wk after surgery were fluctuated (HBV detected rate: 51.4%, 13.3%, 50% respectively; HBV DNA: 3.55±0.674 log(10) copies/mL vs 3.00±0.329 log(10) copies/mL vs 4.608±1.344 log(10) copies/mL, F= 7.582, P= 0.002<0.05). HBV DNA in serum was 4.48±1.463 log(10) copies/mL before surgery and <103 copies/mL after OLT except for one with 5.72×106 copies/mL 4 wk after OLT who was diagnosed as HBV recurrence.The levels of INF-γ, and TNF-α were lower in patients with a high HBV load than in those with a low HBV load (HBV DNA detected/undetected in PBMCs: IFN-γ 138.08±72.44 ng/L vs 164.24±72.07 ng/L, t = 1.065, P = 0.297>0.05, TNF-α 80.75±47.30 ng/L vs74.10±49.70 ng/L, t= 0.407, P= 0.686>0.05; HBV DNA positive/negative: IFN-γ 136.77±70.04 ng/L vs 175.27±71.50 ng/L, t= 1.702, P= 0.097>0.05; TNF-α 75.37±43.02 ng/L vs 81.53±52.46 ng/L, t = 0.402,P = 0.690>0.05).CONCLUSION: The yielding of INF-γ and TNF-α from PBMCs is inhibited significantly by immunosuppressive agents following OLT with HBV load increased, indicating that the impaired immunity of host is associated with HBV recurrence after OLT.展开更多
基金Supported by the Technology Program of Guangdong Province, No. 2004B35001001
文摘AIM: To study the association between host immunity and hepatitis B virus (HBV) recurrence after liver transplantation.METHODS: Peripheral blood mononuclear cells (PBMC) were isolated from 40 patients with hepatitis B and underwent orthotopic liver transplantation (OLT) before and 2, 4, 8 wk after surgery. After being cultured in vitro for 72 h, the levels of INF-γ and TNF-α in culture supernatants were detected with ELISA. At the same time, the quantities of HBV DNA in serum and PBMCs were measured by real time PCR.RESULTS: The levels of INF-γ and TNF-α in PBMC culture supernatants decreased before and 2, 4 wk after surgery in turns (INF-γ 155.52±72.32 ng/L vs14.76±9.88 ng/L vs 13.22±10.35 ng/L, F= 6.946, P = 0.027<0.05; TNF-α80.839±46.75 ng/L vs 18.59±17.29 ng/L vs9.758±7.96 ng/L,F= 22.61, P= 0.0001<0.05). The levels of INF-γ and TNF-α were higher in groups with phytohemagglutinin (PHA) than in those without PHA before surgery. However,the difference disappeared following OLT. Furthermore,INF-γ and TNF-α could not be detected in most patients at wk 4 and none at wk 8 after OLT. The HBV detection rate and virus load in PBMlC before and 2, 4 wk after surgery were fluctuated (HBV detected rate: 51.4%, 13.3%, 50% respectively; HBV DNA: 3.55±0.674 log(10) copies/mL vs 3.00±0.329 log(10) copies/mL vs 4.608±1.344 log(10) copies/mL, F= 7.582, P= 0.002<0.05). HBV DNA in serum was 4.48±1.463 log(10) copies/mL before surgery and <103 copies/mL after OLT except for one with 5.72×106 copies/mL 4 wk after OLT who was diagnosed as HBV recurrence.The levels of INF-γ, and TNF-α were lower in patients with a high HBV load than in those with a low HBV load (HBV DNA detected/undetected in PBMCs: IFN-γ 138.08±72.44 ng/L vs 164.24±72.07 ng/L, t = 1.065, P = 0.297>0.05, TNF-α 80.75±47.30 ng/L vs74.10±49.70 ng/L, t= 0.407, P= 0.686>0.05; HBV DNA positive/negative: IFN-γ 136.77±70.04 ng/L vs 175.27±71.50 ng/L, t= 1.702, P= 0.097>0.05; TNF-α 75.37±43.02 ng/L vs 81.53±52.46 ng/L, t = 0.402,P = 0.690>0.05).CONCLUSION: The yielding of INF-γ and TNF-α from PBMCs is inhibited significantly by immunosuppressive agents following OLT with HBV load increased, indicating that the impaired immunity of host is associated with HBV recurrence after OLT.