基于Th1/Th2细胞因子表达变化探讨扶正祛毒方对慢性HBV携带者的免疫调节机制  

Discussion on the immunoregulatory mechanism of Fuzheng Qudu formula on chronic hepatitis B virus carriers with basis of the expression of Th1/Th2 cytokines

作　　者：郭子宁[1] 张立平 黄象安[1] 彭龙 何光焰 GUO Zining;ZHANG Liping;HUANG Xiangan(Dongfang Hospital of Beijing University of Chinese Medicine,Beijing100078,China)

机构地区：[1]北京中医药大学东方医院感染科,100078 [2]北京中医药大学研究生院

出　　处：《环球中医药》2018年第12期1874-1878,共5页Global Traditional Chinese Medicine

基　　金：国家自然科学基金青年项目(81503473);北京中医药大学基本科研业务面上项目(2015-JYBJSMS112)

摘　　要：目的通过Th1/Th2细胞因子表达的变化探讨扶正祛毒方对慢性乙型肝炎病毒(hepatitis B virus,HBV)携带者的免疫调节作用。方法招募慢性HBV携带患者,随机分为治疗组和对照组,对基线时和治疗12周后两组患者进行组内和组间的一般资料、病毒载量、转氨酶水平、以及Th1类细胞因子γ-干扰素(interferon-γ,IFN-γ)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-2(interleukin-2,IL-2)、Th2类细胞因子白细胞介素-4(interleukin-4,IL-4)、白细胞介素-10(interleukin-10,IL-10)表达的比较。结果基线时两组患者一般资料无显著差异(P> 0. 05);血清乙肝表面抗原(HBs Ag)、乙肝病毒的脱氧核糖核酸(HBV-DNA)滴度、谷氨酸氨基转移酶(alanine aminotransferase,ALT)、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)水平,Th1类细胞因子IFN-γ、TNF-α、IL-2,Th2类细胞因子IL-4、IL-10表达亦无显著差异(P> 0. 05)。扶正祛毒方干预12周后,治疗组血清HBV-DNA和HBe Ag滴度较对照组下降,差异显著(P <0. 05),Th1类细胞因子IFN-γ、TNF-α、IL-2表达较对照组上升,差异显著(P <0. 05);同时Th2类细胞因子IL-4、IL-10表达较对照组下降,差异显著(P <0. 05)。治疗组治疗12周后较基线时血清HBV-DNA和HBe Ag复制水平下降,差异显著(P <0. 05),Th1类细胞因子IFN-γ、TNF-α及IL-2表达较前上升(P <0. 05),Th2类细胞因子IL-4、IL-10表达下降(P <0. 05);对照组12周后与基线时比较,血清HBV-DNA和HBe Ag水平、Th1类细胞因子IFN-γ、TNF-α、IL-2以及Th2类细胞因子IL-4及IL-10表达均无显著差异(P> 0. 05)。结论 (1)扶正祛毒方对慢性乙肝病毒携带者病毒复制有抑制作用(P <0. 05);(2)扶正祛毒方抑制病毒复制同时对肝脏炎症反应无激活(P <0. 05),疗效安全;(3)扶正祛毒方对Th1/Th2类细胞因子具有调节作用(P <0. 05),这可能是其抑制慢性乙肝病毒携带者病毒复制的核心机制。Objective To discuss the immunoregulatory effects of Fuzheng Qudu formula on chronic hepatitis B carrier by observing the changes of Th1/Th2cytokines’expressions.Methods The chronic hepatitis B carriers were recruited and divided them into treatment group and control group in random patterns.Their general information,copies of HBV-DNA,ALT and AST level,the expression of Th1cytokines,interferon-γ(IFN-γ),tumor necrosis factor-α(TNF-α),interleukin-2(IL-2),Th2cytokines IL-4and interleukin-10(IL-10)in serum of each group were respectively recorded and compared on the1st day they enrolled with the day they treated after12weeks.Results On the base line,there was no significant difference between treatment group and control group in general information(P>0.05),the level of HBsAg,HBeAg and copies of HBV-DNA,levels of ALT and AST,nor the expression of cytokines IFN-γ,TNF-α,IL-2,IL-4and IL-10(P>0.05).After12weeks treatment by Fuzheng Qudu formula,the level of HBeAg and copies of HBV-DNA in serum of patients in treatment group was decreased,and the difference was significant(P<0.05).The level of the expression of cytokines IFN-γ,TNF-α,IL-2was increased,and the level of expression of cytokines IL-4and IL-10was decreased.Both the differences were significant(P<0.05).When it came to patients in control group,there were no significant difference compared with base line in the above data(P>0.05).Conclusion Fuzheng Qudu formula can inhibit the copy of HBV-DNA on chronic hepatitis B carrier.The treatment of Fuzheng Qudu formula is safe since it has not stimulated the hepatic inflammatory response when it worked on HBV-DNA control.Fuzheng Qudu formula can regulate the proportion of Th1/Th2cytokines,and it may be the key mechanism in its ability of HBV-DNA control on chronic hepatitis B carrier.

关 键 词：慢性乙型肝炎病毒携带者 扶正祛毒方 免疫调节 细胞因子 

分 类 号：R373.21[医药卫生—病原生物学]