急性乙型肝炎患者FoxP3v^+调节性T细胞数量与功能的随访  

The frequency and function of FoxP3^+ regulatory T cell in patients with acute hepatitis B

作　　者：秦晨溪[1] 高宏伟[1] 彰颖[1] 高蕾[1] 贾凤[1] 邹永红[1] 杨秀清[1] 郭学青[1] 

机构地区：[1]北京军区总医院第263临床部检验科,北京101149

出　　处：《细胞与分子免疫学杂志》2009年第11期1029-1031,共3页Chinese Journal of Cellular and Molecular Immunology

摘　　要：目的:观察急性HBV感染患者外周血FoxP3+CD4+CD25+调节性T细胞(Treg)的数量和功能的变化特点。方法:采集15例急性乙型肝炎(AHB)患者急性期、恢复早期及痊愈后外周血、15例健康人的外周血,分离PBMC,通过MACS免疫磁珠分选CD4+T细胞和Treg,应用实时荧光定量RT-PCR比较AHB患者不同疾病发展阶段(急性期,恢复早期,痊愈后)CD4+T细胞的FoxP3(Forkhead/winged helix tran-scription factor)mRNA表达量的差异,应用3[H]掺入法检测Treg抑制CD4+CD25-T细胞增殖的能力的差异。所有病例及对照均ELISA检测HBsAg、HBsAb、HBeAg、HBeAb、HB-cAb,实时荧光定量RT-PCR检测血清HBV DNA载量,同时进行肝功能检测。结果:AHB患者CD4+T细胞表达FoxP3mRNA的量在急性期稍低于健康对照,在疾病恢复早期明显高于健康对照(t=3.44,P<0.01),痊愈后恢复至正常。Treg抑制CD4+CD25-T细胞增殖的能力在急性期显著低于恢复早期(t=-5.30,P<0.01)和痊愈后(t=-3.20,P<0.05)。结论:Treg在AHB患者急性期数量减少,功能减弱,在恢复早期数量增加,功能增强,提示Treg可能在急性肝炎的不同发病阶段中通过调节细胞免疫反应影响乙肝病毒清除。AIM： To investigate the dynamic variety of frequency and function of FoxP3 ＋ regulatory T cells in patients with acute hepatitis B （AHB）. METHODS： Peripheral blood mononuclear cells （PBMCs） from 15 AHB patients at acute phase （week 1 of illness）, convalescent phase （primary occurrence of both ALT level normalization and HBsAg negative conversion）, resolved phase （at least 8 weeks after both ALT normalization and HBsAg seroconversion, and 15 health subjects were analyzed for FoxP3 （Forkhead/ winged helix transcription factor） mRNA expression in MACS magnetic beads-purified CD4＋ T cells by real-time RT-PCR assay. The effects of Treg cells on the proliferation of CD4 ＋ CD25 - T cells were examined by a 3[ H ] -thymidine incorporation assay. RESULTS： AHB patients presented a significantly higher FoxP3 mRNA expression at convalescent phase than acute phase （t= -6.04, P〈0.01） and resolved phase （ t = 4.45, P 〈 0.01）, and healthy controls （ t = 3.44, P 〈 0.01 ）. We also observed that the suppression efficiency of Treg cells on proliferation of CD4 ＋ CD25 - T cells was lower at acute phase than convalescent phase （ t = - 5.30, P 〈 0.01 ） and resolved phase （ t = - 3.2,0, P 〈 0. 05）, but there was no significant difference between healthy controls and any phase of AHB. CONCLUSION： AHB patients presented lower circulating Treg frequency and suppression function at acute phase, and both of them are increased at convalescent phase, and then return to normal level along with disease resolved. This follow-up study furthers our understanding of Treg＇s role in immunopathogenesis of hepatitis B.

关 键 词：乙型肝炎 调节性T细胞 免疫耐受 致病机理 

分 类 号：R392.12[医药卫生—免疫学]