临床荟萃

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急性乙型肝炎患者pDCs上CD86表达变化及意义

  

  1. 河北中医肝病医院 二病区,河北 石家庄  050800
  • 出版日期:2020-08-20 发布日期:2020-06-24
  • 通讯作者: 沈丽贤, Email: frank.641@163.com
  • 基金资助:
    河北省中医药管理局科学技术研究计划项目----中西医结合在治疗中晚期自身免疫性肝病中的价值(2019492)

Changes and significance of CD86 expression on pDCs in patients with acute hepatitis B

  1. Second Ward,  Hebei Hepatopathy Hospital of TCM,  Shijiazhuang 050800,  China
  • Online:2020-08-20 Published:2020-06-24
  • Contact: Corresponding author: Shen Lixian, Email: frank.641@163.com

摘要: 目的  探讨外周血浆细胞样树突状细胞(pDCs)在急性乙型肝炎(AHB)患者临床转归中的变化及作用。方法  纳入2015年6月至2017年5月收治的急性乙型肝炎(AHB组)患者40例, 给予退黄、降酶、保肝等药物,并加用恩替卡韦0.5 mg空腹口服,1次/d。另纳入健康体检者26例为健康对照组( HC组)。HC组于体检当天、AHB组于治疗前及治疗后6周采集外周静脉全血,采用ELISA法检测2组血浆HBV DNA、HBsAg、HbeAg及肝功能指标水平,并应用流式细胞仪检测pDCs的频数及其功能分子CD86的表达水平。结果  治疗6周后,AHB组临床症状显著缓解,血清学指标和乙型肝炎标志物水平显著下降(P<0.01)。治疗6周后,AHB组HBV DNA转阴率为82.5%,HBsAg清除率为72.5%,HBeAg血清学转换率为75.0%,与治疗前比较差异均有统计学意义(P<0.01), HC组pDCs频数显著高于AHB组治疗前。AHB组治疗后CD86+pDCs显著高于治疗前。HC组CD86ABC显著低于AHB组治疗前。结论  在急性乙型肝炎患者外周血pDCs的数量降低。急性乙型肝炎患者在治疗后CD86+pDCs增多。急性乙型肝炎患者pDCs上CD86表达上调。

关键词: 乙型肝炎病毒, 树突细胞, 免疫反应

Abstract: Objective   To explore the changes and functions of plasmacytoid dendritic cells (pDCs) in peripheral blood of patients with acute hepatitis B (AHB) in clinical outcome. Methods   Totally 40 AHB patients (AHB group) were selected from June 2015 to May 2017. They were treated with drugs to relieve jaundice,  reduce enzyme activity and protect liver. They were also given 0.5 mg oral entecavir on an empty stomach once a day. And 26 healthy people were selected as health control group (HC group). The whole blood samples were obtained from AHB group six weeks before and after the treatment,  and from HC group at the time of medical examination,  respectively.  ELISA method was used to detect the levels of HBV DNA,  HBsAg,  HBeAg and liver function indexes,  and flow cytometry was used to detect the frequency of pDCs and the expression level of CD86. Results  After six weeks of treatment,  the clinical symptoms of AHB group were significantly relieved,  and the levels of serological indicators and hepatitis B markers significantly decreased(P<0.01). The negative conversion ratio of HBV DNA in AHB patients was 82.5%,  the clearance rate of HBsAg was 72.5%,  and the serological conversion rate of HBeAg was 75.0%. There were statistically significant differences before and after the treatment (P<0.01). The frequency of pDCs in HC group was higher than that in AHB group before the treatment.  The expression level of CD86 on pDCs in AHB patients after the treatment was higher than before. CD86ABC in HC group was obviously lower than that in AHB group before the treatment. Conclusion  The frequency of pDCs in peripheral blood decreased in AHB group. The CD86 on pDCs increased in AHB patients after the treatment. The expression of CD86 on pDCs in AHB patients was upregulated.

Key words: hepatitis B virus;dendritic cells, immunoreaction