自身免疫性肝炎患者肝组织程序性细胞死亡因子配体1的表达及其与肝功能的相关性  

Expression of programmed cell death ligand 1 in liver tissue and its correlation with liver function of patients with autoimmune hepatitis

作　　者：柯坤宇[1] 熊克宫[1] 魏大海[1] 陈丽芳[1] 孔金峰[1] 孙芳[1] 潘晨[1] 

机构地区：[1]福州市传染病医院,福建医科大学孟超肝胆医院肝病科,350025

出　　处：《中华传染病杂志》2016年第10期577-581,共5页Chinese Journal of Infectious Diseases

基　　金：福州市卫生系统科技计划项目（2014-S-w21）

摘　　要：目的：研究程序性细胞死亡因子配体1（PD-L1）在自身免疫性肝炎（AIH）患者肝组织中的表达情况及其与肝功能的相关性，探讨其在 AIH 发生、发展中的作用。方法收集31例活动期 AIH 患者（包括5例重度炎症组、8例中度炎症组和18例轻度炎症组）和12例缓解期 AIH 患者肝组织，并选择9例肝血管瘤手术者正常肝组织为对照组，用免疫组织化学方法结合图像定量分析系统检测 AIH 患者和对照组肝组织内PD-L1的表达情况。结果 AIH 活动期组肝组织 PD-L1为（9．47±4．67）％，高于缓解期组的（4．78±2．43）％和对照组的（1．48±0．32）％（t 值分别为4．95、8．18，均 P〈0．05），且缓解期组高于对照组（t＝3．84，P 〈0．05）；AIH 重度炎症组、中度炎症组、轻度炎症组和缓解期组患者肝组织 PD-L1逐渐下降，分别为（13．81±4．93）％、（10．14±3．36）％、（7．43±2．28）％和（4．78±2．43）％（均 P〈0．05），且 PD-L1水平与肝组织炎症活动度呈正相关（r＝0．867，P〈0．05），而肝组织 PD-L1在不同肝组织纤维化程度 AIH 患者的表达差异无统计学意义（F＝1．37，P〉0．05）。AIH 患者肝组织 PD-L1与 TBil、ALT、IgG 水平均呈正相关（r 值分别为0．798、0．687、0．739，均 P〈0．05）。结论 PD-L1在 AIH 患者肝组织中表达上调，且与肝组织炎症活动度及肝功能呈正相关，提示PD-L1可能参与 AIH 的发生及发展。Objective To investigate the expression of programmed cell death ligand 1 （PD-L1）in liver tissue and its correlation with liver function indicators in patients with autoimmune hepatitis （AIH）,and to explore the role of PD-L1 in the initiation and development of AIH.Methods Liver tissues from 31 AIH patients at active stage and 12 at remission stage were collected,different levels of inflammation were indicated by liver biopsy that 5 sever cases,8 moderate cases and 18 mild cases.Liver tissues from 9 healthy cases were selected as controls.The expression of PD-L1 was determined by immunohistochemistry and computer image quantitative analysis in liver tissue of patients with AIH and healthy controls.Results The expression of PD-L1 in liver tissue of patients at active stage were （9.47 ±4.67）%,which was significantly higher than those at remission stage （4.78±2.43）% and control group （1.48±0.32）% （t=4.95 and 8.18,respectively;both P〈0.05）.The expression of PD-L1 in liver tissue gradually declined in patient with severe inflammation （13.81 ±4.93）%,moderate inflammation （10.14 ± 3.36）%,mild inflammation （7.43±2.28）%,and remission stage （4.78±2.43）% （all P〈0.05）,and PD-L1 expression level was positively correlated with inflammation grading of liver tissue （r=0.867,P〈0.05）.However,PD-L1 expression in liver tissue of AIH patients with different liver fibrosis stage were not significantly different （F=1.37,P〉0.05）.The expression of PD-L1 in liver tissue was positively correlated with levels of TBil,ALT and IgG （r = 0.798,0.687,and 0.739, respectively,all P〈0.05）.Conclusions The PD-L1 expression increases in liver tissues of patients with AIH and is positively correlated with inflammation activity of liver tissue and liver function,which indicates that PD-L1 may play an important role in the pathogenesis of AIH.

关 键 词：肝炎 自身免疫性 程序性细胞死亡因子配体 1 蛋白 人 肝组织 免疫组织化学 肝功能指标 

分 类 号：R575.1[医药卫生—消化系统]