CIK联合核苷(酸)类药物治疗慢性乙型肝炎患者Th1/Th2类细胞功能变化  

Dynamic changes of Th1/Th2 type cell function during the treatment of autologous cytokine-induced kill cells combined with nucleoside(acid)analogues in chronic hepatitis B patients

作　　者：王少扬[1,2] 刘海周[1,2] 马卫闽[1,2] 王贤[1,2] 谢丽平[1,2] 谢志红[1,2] 

机构地区：[1]南京军区福州总医院感染科 [2]福建医科大学福总临床医学院传染病学教研室,福州350003

出　　处：《肝脏》2015年第7期522-525,共4页Chinese Hepatology

基　　金：福建省自然科学基金项目(2011J01236)

摘　　要：目的观察核苷(酸)类药物联合CIK治疗慢性乙型肝炎患者Th1/Th2类细胞功能变化,为维持持久免疫应答,减少核苷(酸)类药物停药后复发提供理论依据。方法15例慢性乙型肝炎患者在核苷(酸)类药物治疗达到HBV DNA检测水平下限时给予CIK治疗,分别在核苷(酸)类药物治疗前、HBV DNA达到检测水平下限以及CIK治疗后2周3个时间点采用流式细胞术检测Th1/Th2类细胞功能,10例单独接受CIK治疗和10例单独接受核苷(酸)类药物治疗的慢性乙型肝炎患者作为对照组。结果无论是观察组还是对照组,当接受核苷(酸)类药物并HBV DNA水平达到不可检测水平以下时,CD4细胞产生IFN-γ水平明显升高(1.511±1.026 vs 2.139±0826,1.656±0.869 vs 2.511±1.133,P<0.05),IL-4水平无明显变化,单独接受CIK治疗后IFN-γ水平也明显增高(1.434±0.924 vs 2.211±0.921,P<0.05),IL-4水平无明显变化,同前两组比较IFN-γ水平和IL-4水平均无差异。核苷(酸)类药物联合CIK治疗后相比单独CIK治疗和单独核苷(酸)类药物治疗,不但IFN-γ明显增高(3.288±0.561 vs 2.211±0.921,3.288±0.561 vs 2.511±1.133,P<0.05),并且IL-4水平也降低(0.277±0.237 vs 0.428±0.208,0.277±0.237 vs 0.477±0.255,P<0.05)。结论核苷(酸)类药物联合CIK治疗明显提高Th1类细胞应答,并抑制Th2类细胞功能,但是否持久维持Th1类细胞免疫应答还需要进一步研究。Objective To investigate the metergasis of Th1/Th2 types cells in chronic hepatitis B（CHB）patients during the treatment of autologous cytokine-induced kill cells combined with nucleoside（acid）analogues therapy.MethodsFifteen CHB patients received CIK combined with nucleoside（acid）analogues were enrolled,while another 20 CHB patients only received CIK or nucleoside（acid）analogues were enrolled as control group.Detection of HBV DNA levels and liver functions were carried out during the treatment.The function of Th1/Th2 types cell were assessed by flow cytometry.Results The level of interferon-γ（IFN-γ＇,cytokines of Th1 type）was significantly increased after HBV DNA levels under the limit of detection during nucleoside（acid）analogues therapy,wnich was also observed in patients with CIK treatment.However,the level of interleukin-4（IL-4,cytokines of Th2 type）was not varied significantly.Compared with control group,the level of IFN-γwas significantly increased in treatment group of CIK combined with nucleosidec（acid）analogues at 2 weeks after treatment,however the level of IL-4 was significanthy decreased.Conclusion CIK combined with nucleoside（acid）analogues can increase the release of IFN-γ（cytokines of Th1 type）,whereas inhibit IL-4（cytokines of Th2 type）levels,wnich may be related to the recovery of Th1/Th2 balance.

关 键 词：乙型肝炎 细胞因子诱导的杀伤细胞 Th1/Th2类细胞 核苷(酸)类药物 

分 类 号：R512.62[医药卫生—内科学]