慢性乙型肝炎患者外周血单个核细胞中辅助性T细胞及巨噬细胞分化相关基因表达与干扰素治疗敏感性的相关性探讨  

Study on the relationship between Th lymphocyte and macrophage differentiation related genes expression within human peripheral blood mononuclear cells and sensitivity of Interferon treatment in chronic hepatitis B patients

作　　者：沈桂堂[1] 张丽丽[1] 窦宇明[1] 胡丽娜[1] 

机构地区：[1]江苏省泰州市人民医院肝科,江苏泰州225300

出　　处：《中西医结合肝病杂志》2015年第5期271-273,共3页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

摘　　要：目的:观察慢性乙型肝炎(CHB)患者外周静脉血单个核细胞(PBMCs)中,辅助性T细胞(Th)、单核/巨噬细胞分化相关基因的表达水平,研究其与干扰素(IFN)疗效的关系。方法:依据2005年《慢性乙型肝炎防治指南》提出的CHB诊断标准选取患者,分为应答组、无应答组,另设健康对照组。采集各组人员外周静脉血分离出PBMCs,用反转录聚合酶链反应(RT-PCR)法检测PBMCs中Th相关基因SOCS1、SOCS3、T-bet、ROR t,单核/巨噬细胞相关基因IL-12a、NOS2、CCL17以及CDH的m RNA表达水平。结果:CHB患者接受干扰素治疗后,无应答组患者SOCS1及SOCS3的表达水平均显著高于其他两组(<0.01),无应答组患者Th1分化相关的T-bet基因表达显著低于应答组(<0.01),而与Th17分化相关的ROR t基因的表达显著高于应答组;无应答组患者与M1相关的基因IL-12a及NOS2均显著低于应答组(<0.01),而与M2相关的基因CCL17以及CDH1的表达显著高于应答组(<0.01)。结论:IFN能有效刺激机体产生Th1反应,但机体是否对治疗敏感要取决于人体内部免疫环境的调节,CHB患者PBMCs中辅助性T细胞及巨噬细胞相关基因的表达与干扰素治疗的效果具有内在联系,可以作为判断疗效的辅助指标。Objective：To investigate Th lymphocyte and macrophage differentiation related genes expression in human peripheral blood mononuclear cells of chronic hepatits B patients,and its relationship with sensitivity of Interferon treatment. Methods： The patients were selected based on the＂Guide to prevention and treatment of chronic hepatitis B＂,the candidates were divided into response,non-response and health control groups. Th lymphocyte related gene（SOCS1,SOCS3,T-bet and ROR t） and macrophage related genes（IL-12 a,NOS2,CCL17 and CDH） were detected by real-time PCR,and the significance was analyzed by using SPSS. Results： SOCS1 and SOCS3 were significantly increased in non-response group compared with response and health control groups, and Th1 related gene T-bet was significantly decreased,however,Th17 related gene ROR t increased significantly,M1 related genes IL-12 a and NOS2 decreased while M2 related genes CCL17 and CDH1 increased in the non-response group. At the same time,the expression of Th1 and M1 related genes in the PBMCs of response group were significantly up-regulated,while Th17 and M2 related genes were down regulated. Conclusion： IFN can induce Th1 response,but the sensitivity of the treatment was varied individually,Th lymphocyte and macrophage related genes were related to the effects of treatment and can be served as indices of treatment.

关 键 词：肝炎 乙型 慢性 干扰素 辅助性T淋巴细胞 巨噬细胞 

分 类 号：R512.62[医药卫生—内科学]