α-干扰素治疗慢性乙型肝炎患者外周血调节性T细胞比例及单核细胞程序性死亡受体-1配体表达的变化及意义  

The effect of interferon-α therapy on the variations and the significance of Treg percentage and PD-L1 expression on monocytes in the peripheral blood in patients with chronic hepatitis B

作　　者：辛杰晶[1] 潘修成[1] 毛娟娟[1] 任劲松[1] 刘梅[1] 李丽[1] 

机构地区：[1]徐州医学院附属医院感染性疾病科,江苏徐州221002

出　　处：《徐州医学院学报》2011年第3期163-165,共3页Acta Academiae Medicinae Xuzhou

基　　金：江苏省卫生厅科研基金（H200614）;徐州市科委科研基金（XM08C079）

摘　　要：目的 分析α-干扰素治疗过程中慢性乙型肝炎患者（CHB）外周血调节性T细胞（Treg）比例及单核细胞程序性死亡受体-1配体（PD-L1）分子表达的变化及其临床意义.方法 21例HBeAg阳性CHB患者接受α-干扰素治疗24周,用流式细胞仪检测治疗前后外周血Treg比例和单核细胞PD-L1表达水平,采用荧光定量聚合酶链反应（PCR）检测治疗前后血清乙型肝炎病毒（HBV DNA）水平,通过时间分辨荧光免疫法检测治疗前后乙型肝炎病毒标志物,全自动生化分析仪检测治疗前后谷氨酸氨基转移酶（ALT）水平.结果 治疗前CHB患者外周血Treg比例和单核细胞PD-L1表达水平与HBV DNA水平成正相关;治疗24周后,Treg水平明显下降,而单核细胞PD-L1表达无明显变化.在不同应答病例,治疗24周后外周血Treg和单核细胞PD-L1水平较治疗前变化不同.结论 CHB患者外周血Treg和单核细胞PD-L1水平影响α-干扰素抗HBV疗效,测定外周血Treg比例和单核细胞PD-L1的表达,可作为α-干扰素抗HBV疗效预测的免疫学指标之一.Objective To investigate the effect of interferon - α therapy on the proportion of CD4 ^＋ CD25 ^＋ regulatory T cells （Treg） and PD -L1 expression on monocytes in the peripheral blood in patients with chronic hepatitis B. Methods Twenty - one patients with HBeAg - positive chronic hepatitis B （ CHB ） were recruited and underwent interferon - α treatment for 24 weeks. Before and after treatment, the percentages of peripheral blood Tregs and levels of PD - L1 expression on monocytes were detected by flow cytometry, serum HBV DNA levels were assayed by fluorescent quantitative polymerase chain reaction （FQ -PCR）, the HBV markers were assayed by time resolved fluoroisnmunoassay （TRFIA）, and levels of alanine aminotransferase （ALT） in the serum were determined by a chemistry -immuno analyzer. Results Prior to the antiviral therapy, the percentages of Treg or levels of PD - L1 expression on monocytes in the peripheral blood in patients with CHB were positively correlated with serum HBV DNA levels ; The percentages of Treg significantly decreased at the end of 24 - week treatment with interferon - α, while no marked variations were observed in the levels of PD - L1 expression on monocytes. In complete response group, however, both the percentages of Treg and the levels of PD - L1 expression on monocytes significantly decreased at the end of 24 - week treatment ; in partial response group, there was an significant decrease in the percentages of Treg, while no evident decline was observed in the ievels of PD - L1 expression. In non - response group, there was no evident variation in either the percentages of Treg or the levels of PD - L1 expression on monocytes. Conclusion The efficacy of interferon - α treatment is susceptible to the percentages of Treg and levels of PD - L1 expression on monocytes, and the determination of the percentages of Treg and levels of PD - L1 expression on monocytes can serve as an predictive index to the efficacy of IFN - α treatment in patients with HBeAg - positi

关 键 词：慢性乙型肝炎 α-干扰素 CD4^+CD25^+调节性T细胞 PD-L1 单核细胞 

分 类 号：R512.62[医药卫生—内科学] R979.5[医药卫生—临床医学]