慢性丙型肝炎患者外周血若干细胞免疫的评价及意义分析  

Evaluation of some cellular immunologic index in chronic hepatitis C patients and its significance

作　　者：陈智[1] 张萍[1] 陈峰[1] 李敏伟[1] 周慧明[1] 刘继洪[1] 沈毅[2] 范维薇[1] 

机构地区：[1]浙江大学医学院附属第一医院传染病研究所,310003 [2]浙江大学医学院生物统计教研室

出　　处：《中华传染病杂志》2004年第4期246-249,共4页Chinese Journal of Infectious Diseases

基　　金："十五"国家科技攻关项目 (2 0 0 1BA70 5B0 6)

摘　　要：目的　探讨丙型肝炎病毒 (HCV)感染慢性化的原因及免疫发病机制。方法　对慢性丙型肝炎 (CHC)患者外周血CD3、CD4、CD8及自然杀伤 (NK)细胞数、细胞趋化因子受体 6 (CCR6 )、干扰素 γ受体 (IFN γRα)用流式细胞仪进行了检测 ,用酶联免疫吸附 (ELISA)法检测外周血Th1、Th2类细胞因子IFN γ、IL 10 ,并对它们之间的相互关系进行了分析。结果　CHC患者外周血中T淋巴细胞总数、CD4、CD8及NK细胞数均显著下降 ;IFN γRα的表达降低 ,IFN γ、IL 10浓度及IFN γ/IL 10 (Th1/Th2 )比例均显著低于对照组 ,以IFN γ的下降尤为明显 ,但CCR6的表达较对照组明显升高。结论　CHC外周T淋巴细胞、NK细胞数量减少 ,淋巴细胞表面IFN γRα表达降低、血清IFN γ、IL 10水平及IFN γ/IL 10比例均下降 ,存在Th1/Th2比例倒置 ,这可能是CHC患者机体免疫功能低下 ,引起病毒持续感染的原因之一 ;同时CHC患者CCR6表达增高 ,可介导部分激活的效应性T细胞向肝脏内迁移 ,参与局部免疫反应 ,这可能是CHC重要发病机制。Objective To investigate the cause of HCV persistent infection and its immuno pathogenesis. Methods The levels of CD3, CD4, CD8, NK cells, cell cytokine receptor 6 (CCR6) and IFN γRα of chronic hepatitis C (CHC) and control group were assayed by flow cytometry. The concentrations of IFN γ and IL 10 in serum were also assayed with ELISA. Results The levels of CD3,CD4,CD8,NK,the concentration of IFN γ and IL 10,and the ratio of IFN γ/IL 10(Th1/Th2) of CHC were obviously lower compared with the control group, especially the IFN γRα,but CCR6 of CHC was higher expressed than that of control group. Conclusions The decreases of lymphocytes in peripheral blood, expression of IFN γRα,the level of IFN γ, IL 10 and the reverse ratio of the Th1/Th2 of CHC might be one reason of the immunity inhibition and lead to HCV persistent infection. The increase of CCR6 of CHC might mediate the migration of activated T lymphocytes to the liver, which might participate in the local immune reaction and take an important role in the pathogenesis of CHC.

关 键 词：IFN-Γ CHC 患者 外周血 IL-10 表达 慢性丙型肝炎 意义 倒置 激活 

分 类 号：R512.6[医药卫生—内科学]