慢性丙型肝炎患者外周血滤泡辅助性T淋巴细胞表面PD-1受体表达及意义研究  

Comparison of PD-1 receptor on peripheral blood follicular helper T lymphocyte surface in chronic hepatitis C patients with low and high serum viral loads

作　　者：吴静[1] 东保吉[2] 吴超[1] Wu Jing;Dong Baoji;Wu Chao(Department of Infectious Diseases,First People's Hospital,Kashi 844000,Xinjiang Uyghur Autonomous Region,China)

机构地区：[1]喀什地区第一人民医院感染病科,新疆维吾尔自治区喀什市844000 [2]新疆医科大学第六附属医院感染办公室

出　　处：《实用肝脏病杂志》2019年第2期192-195,共4页Journal of Practical Hepatology

基　　金：新疆维吾尔自治区自然科学基金资助项目(编号:54200152)

摘　　要：目的探讨不同血清病毒载量的慢性丙型肝炎(CHC)患者外周血滤泡辅助性T淋巴细胞(Tfh)表面程序性死亡受体-1(PD-1)表达情况。方法根据血清HCV RNA水平不同,将180例CHC患者分为低病毒载量组76例,3 lg copies/ml≤血清HCV RNA <6 lg copies/ml和高病毒载量组104例,血清HCV RNA≥6 lgcopies/ml。比较两组外周血Tfh细胞百分比、Tfh细胞表面PD-1阳性率、外周血T、B淋巴细胞亚群、外周血CD4^+T淋巴细胞和CD8^+T淋巴细胞表面PD-1表达和血清白细胞介素21(IL-21)水平的差异。结果低病毒载量组和高病毒载量组血清HCV RNA水平分别为(4.5±1.2)lg copies/ml和(6.4±0.7)lg copies/ml,Tfh细胞表面PD-1阳性百分比分别为(26.2±2.2)%和(37.2±1.1)%,Tfh细胞百分比分别为(7.9±0.7)%和(5.1±0.4)%,血清IL-21水平分别为(46.8±1.3) ng/L和(21.7±1.1) ng/L,差异均有统计学意义(P<0.01);低病毒载量组和高病毒载量组外周血CD4^+T细胞百分比分别为(51.1±4.6)%和(37.6±4.4)%,CD8^+T细胞百分比分别为(24.0±3.1)%和(31.7±3.9)%,CD4^+T/CD8^+T细胞比值分别为(3.3±0.2)和(2.3±0.1),CD19^+B细胞百分比分别为(16.7±3.9)%和(11.8±3.2)%,差异具有统计学意义(P<0.01);低病毒载量组和高病毒载量组外周血CD4^+T细胞表面PD-1阳性率分别为(10.1±2.3)%和(2.4±0.6)%],CD8^+T细胞表面PD-1阳性率分别为(6.3±2.2)%和(1.0±0.3)%,差异也具有统计学意义(P<0.01)。结论不同血清病毒载量的CHC患者外周血Tfh和T淋巴细胞亚群以及血清白细胞介素21水平存在显著差异,进一步探讨它们对病情、抗病毒治疗应答和预后的关系,将具有十分重要的临床意义。Objective To compare the difference of programmed cell death receptor-1(PD-1)receptor on peripheral blood follicular helper T lymphocyte(Tfh)surface in chronic hepatitis C(CHC)patients with low and high serum viral loads.Methods 180 patients with CHC were divided into two group,and 76 had serum HCV RNA level of less than 6 lg copies/ml and 104 had serum HCV RNA level of greater than 6 lg copies/ml.The percentage of PD-1 on peripheral blood Tfh cell surface,percentage of Tfh,peripheral blood T and B lymphocyte subsets and serum interleukin 21(IL-21)level were detected.Results In patients with low and high viral load groups,serum HCV RNA levels were(4.5±1.2)lg copies/ml and(6.4±0.7)lg copies/ml,the percentages of PD-1 on Tfh cell surface were(26.2±2.2)%and(37.2±1.1)%,the percentages of Tfh cells were(7.9±0.7)%and(5.1±0.4)%,and serum IL-21 levels were(46.8±1.3)ng/l and(21.7±1.1)ng/l,all significantly different between the two groups(P<0.05);the percentages of CD4^+T lymphocyte were(51.1±4.6)%and(37.6±4.4)%],the percentages of CD8^+T cell were(24.0±3.1)%and(31.7±3.9)%],the ratios of CD4^+T/CD8^+T cells were(3.3±0.2)and(2.3±0.1)],the percentage of CD19^+B cell were(16.7±3.9)%and(11.8±3.2)%,all significantly different between the two groups(P<0.05);the percentages of PD-1 on CD4^+T lymphocyte surface were(10.1±2.3)%and(2.4±0.6)%],and the percentages of PD-1 on CD8^+T cell surface were(6.3±2.2)%and(1.0±0.3)%(both P<0.01).Conclusion There were significant differences between patients with low and high serum HCV RNA loads as respect to their peripheral blood Tfh and PD-1 expression,which might be important in evaluating the response to antiviral therapy and prognosis.

关 键 词：慢性丙型肝炎 病毒载量 滤泡辅助性T淋巴细胞 程序性死亡受体1 白细胞介素21 

分 类 号：R512.63[医药卫生—内科学]