慢性乙型肝炎患者在HBV不同抗原负载下树突状细胞功能的变化  

Functional status of dendritic cells induced by different hepatitis B virus antigen in chronic hepatitis B patients

作　　者：谢丽平[1,2] 林涛发 朱玲玲[1,2] 王少扬[1,2] 

机构地区：[1]南京军区福州总医院感染科,福州350003 [2]厦门大学附属东方医院感染病学教研室

出　　处：《肝脏》2017年第7期594-596,共3页Chinese Hepatology

基　　金：福建省科技计划项目重点项目(2013Y0073)

摘　　要：目的观察在不同HBV抗原负载下树突状细胞(DC)功能的变化及在核苷(酸)类药物抗病毒治疗后DC的功能变化。方法分离17例慢性乙型肝炎患者外周血单个核细胞(PBMC),并在不同抗原负载下(HBsAg、HBcAg、HBsAg联合HBcAg)诱导DC分化成熟,用流式细胞技术测定DC表面共刺激分子CD80、CD83、CD1a及HLA-Ⅱ类分子HLA-DR表达水平,同时用淋巴细胞增殖试验评估DC功能。结果与负载HBsAg诱导相比,HBcAg、HBsAg联合HBcAg诱导下DC共刺激分子表达明显增强(HLA-DR:85.12±1.55比98.37±1.27比99.21±1.33;CD1a:15.69±2.46比16.25±2.33比42.20±1.10;CD80:71.88±6.38比80.74±3.23比94.70±2.77;CD83:32.64±2.77比42.55±2.88比44.16±1.89)。淋巴细胞增殖试验提示DC功能改善更显著,尤其HBsAg联合HBcAg诱导DC功能改善更加明显(HBV DNA阳性:7.29±0.17比7.99±0.43比8.56±0.31;HBV DNA阴性:7.48±0.30比8.22±0.41比8.78±0.31)。将17例慢性乙型肝炎患者在核苷(酸)类药物抗病毒治疗前后DC功能进行比较,经抗病毒治疗在充分抑制HBV DNA复制的情况下,DC功能的恢复更趋于完善(HLA-DR:99.21±1.33比99.82±2.67;CD1a:42.20±1.10比71.33±5.89;CD80:94.70±2.77比96.42±3.56;CD83:44.16±1.89比68.34±2.11)。结论 HBsAg联合HBcAg诱导DC细胞功能明显得到恢复和增强,HBV DNA阴性时诱导自体DC功能恢复更趋完善。Objective To investigate the functional changes of dendritic cells(DC)from chronic hepatitis B(CHB)patients upon stimulation of different hepatitis B virus antigen and treated with antiviral drugs.Methods Monocytes,isolated from peripheral blood mononuclear cells(PBMC)in17 CHB patients,were induced into mature DC with hepatitis B core antigen(HBcAg),hepatitis B surface antigen(HBsAg),and HBcAg combination with HBsAg,respectively.Costimulatory molecules on DC surface,including CD1 a,CD80,CD83 and human leukocyte antigen DR(HLA-DR),were analyzed using flow cytometry.The functions of DC were evaluated using allogeneic mixed lymphocyte reaction assay.Results Compared with those in HBsAg-induced DC,levels of CD1 a,CD80,CD83 and HLA-DR were higher on DC induced by HBcAg alone,as well as HBsAg combination with HBcAg(HLA-DR:85.12±1.55 vs.98.37±1.27 vs.99.21±1.33;CD1a:15.69±2.46 vs.16.25±2.33 vs.42.20±1.10;CD80:71.88±6.38 vs.80.74±3.23 vs.94.70±2.77;CD83:32.64±2.77 vs.42.55±2.88 vs.44.16±1.89).The mixed lymphocyte reaction ability of DC showed the similar pattern(HBV DNA+:7.29±0.17 vs.7.99±0.43 vs.8.56±0.31;HBV DNA-:7.48±0.30 vs.8.22±0.41 vs.8.78±0.31).After anti-viral therapy,functional status of DC,such as co-stimulatory molecules expression and the mixed lymphocyte reaction ability,were improved more obviously than those at baseline(HLA-DR:99.21±1.33 vs.99.82±2.67;CD1a:42.20±1.10 vs.71.33±5.89;CD80:94.70±2.77 vs.96.42±3.56;CD83:44.16±1.89 vs.68.34±2.11).Conclusion The dysfunction of DC as the important phagocytes from CHB patients might be improved and recovered through combined induction with HBsAg and HBcAg,which could be further relived after anti-viral therapy.It provides a effective and potential therapy for CHB.

关 键 词：慢性乙型肝炎 树突状细胞 乙型肝炎表面抗原 乙型肝炎核心抗原 

分 类 号：R512.62[医药卫生—内科学]