儿童慢性乙型肝炎患者树突细胞亚群的检测及其临床意义  

Detection and clinical significance of dendritic cell subsets in pediatric patients with chronic type B hepatitis

作　　者：姚金霞[1] 张鸿飞[2] 张政[1] 陈大为[2] 张晖[1] 福军亮[1] 金磊[1] 王福生[1] 

机构地区：[1]解放军第302医院生物治疗中心,北京100039 [2]解放军第302医院 感染五科,北京100039

出　　处：《解放军医学杂志》2007年第8期817-819,共3页Medical Journal of Chinese People's Liberation Army

摘　　要：目的观察儿童慢性乙型肝炎患者外周血和肝内树突细胞(DC)及其亚群的特征,分析它们与乙型肝炎病毒(HBV)清除的关系。方法选择10例免疫耐受患儿(免疫耐受组)、20例免疫激活患儿(免疫激活组)和14名健康儿童(健康组),利用流式细胞技术检测外周血髓样树突细胞(mDC)和浆样树突细胞(pDC)的百分比,分别用poly I:C和CpG ODN2216刺激外周血单个核细胞,检测mDC产生白介素12(IL-12)和pDC产生干扰素α(IFN-α)的能力;利用免疫组化技术检测肝内mDC和pDC的数量。结果免疫激活组mDC和pDC的百分比(分别为0.39%±0.17%和0.22%±0.13%)明显低于免疫耐受组(0.52%±0.21%和0.28%±0.10%)、健康组(0.47%±0.20%和0.36%±0.19%),差异有显著性(P<0.05)。患儿DC数量与血清ALT呈明显负相关,与HBV DNA病毒载量无明显相关性。免疫激活组CpG刺激产生IFN-α的量(464.8±381.8pg/ml)明显低于免疫耐受组(822.3±327.2pg/ ml)和健康组(866.0±311.1pg/ml,P<0.05),而免疫耐受组与健康组之间无显著性差异(P>0.05)。DC在poly I:C刺激下产生IL- 12的能力三组无明显差异。同时还发现免疫激活患儿肝内的mDC和pDC数量均明显增加。结论儿童慢性乙型肝炎患者外周DC数量的下降可能与局部的免疫反应有关。Objective To characterize the dendritic cell subsets in peripheral blood and liver of pediatric patients with chronic type B hepatitis, and to analyze its correlation with HBV clearance. Methods 10 children at immune tolerant stage, 20 children at immune active stage and 14 healthy children as control were enrolled in present study. Depending on the flow cytometric analysis, proportion of myeloid DC （mDC） and plasmatoid DC （pDC） were detected. The capability of IFN-α production by pDC and IL-12 production by mDC were investigated, when PBMC were stimulated with poly I：C and CpG ODN2216 respectively. The number of pDC and mDC in liver were also assessed with immunohistochemical techniques. Results The number of mDC and pDC in immune active group （mDCs, 0. 39%±0. 17%; pDCs, 0. 22% ±0. 13%, P〈0. 05） was decreased significantly as compared with that in immune tolerant group （mDCs, 0. 52% ±0. 21% pDCs, 0. 28 % ±0. 10 %） and healthy controls （rnDCs, 0. 47 %±0. 20 %; pDCs, 0.36 % ±0. 19 % ）. The number of DCs was negatively related to serum ALT level, and there was no correlation with HBV load apparently. The IFN-α production was lowered remarkably in immune active group when stimulated with CpG （464. 8±381.8pg/rnl, P〈0. 05）, but no difference was found between the immune tolerant group （822. 3±327. 2pg/ml） and healthy controls （866. 0±311. 1pg/ml）. The ability of IL-12 production by DC was comparable among three groups. In addition, it was found that the number of liver pDC and rnDC increased significantly in children in immune active stage. Conclusion The decrease of peripheral DCs in chronic HBV-infected children may be related with local immune response.

关 键 词：肝炎 乙型 慢性 树突细胞 干扰素Α 免疫耐受 儿童 

分 类 号：R725.751[医药卫生—儿科]