HBeAg阳性慢性乙型肝炎发病与浆细胞样树突状细胞功能的研究  

Study on the pathogenesis of HBeAg-positive chronic hepatitis B and plasmacytoid dendritic cells function

作　　者：路遥 曹卫华 陈琦琪 陆慧慧 张璐 申戈 吴淑玲 郝红晓 常敏 刘如玉 高媛娇 胡蕾苹 李明慧 谢尧 Lu Yao;Cao Weihua;Chen Qiqi;Lu Huihui;Zhang Lu;Shen Ge;Wu Shuling;Hao Hongxiao;Chang Min;Liu Ruyu;Gao Yuanjiao;Hu Leiping;Li Minghui;Xie Yao(Division 2,Department of Hepatology,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China;Department of Infectious Diseases,Miyun Teaching Hospital,Capital Medical University,Beijing 101500,China)

机构地区：[1]首都医科大学附属北京地坛医院肝病二科,北京100015 [2]首都医科大学密云教学医院,北京101500

出　　处：《中华实验和临床病毒学杂志》2020年第4期435-439,共5页Chinese Journal of Experimental and Clinical Virology

基　　金：国家科技重大专项(2017ZX10201201-001-006和2017ZX10201201-002-006);首都临床特色应用研究专项资助课题(Z151100004015122);北京市科技计划子课题(D161100002716002);北京市医院管理中心消化内科学科协同发展中心资助课题(XXZ0302和XXT28);北京市医院管理局临床医学发展专项经费资助(XMLX 201706)。

摘　　要：目的探讨e抗原(hepatitis B e antigen,HBeAg)阳性的慢性乙型肝炎(chronic hepatitis B,CHB)发病与浆细胞样树突状细胞(plasmacytoid dendritic cell,pDC)频数及功能相关性。方法入组HBeAg阳性CHB患者,包括免疫耐受期(immune tolerance,IT)患者49例和免疫清除期(immune clearance,IC)患者100例。检测其病毒血清学指标及肝功能等,并采集外周静脉血,流式细胞仪检测外周血pDC频数及表面共刺激分子Cluster of Differentiation 86CD86定量表达,分析CHB发病与pDC频数及功能相关性。结果IC组与IT组比较,HBV表面抗原(hepatitis B surface antigen,HBsAg)s水平、HBeAg水平和HBV DNA载量有显著差异;IC组谷丙转移酶(alanine aminotransferase,ALT)水平显著高于IT组;IC组pDC百分率(%)显著低于IT组;IC组和IT组的CD86^+pDC%和CD86平均荧光强度(mean fluorescentintensity,MFI)无显著差异。IC患者基线pDC%与ALT水平负相关,而ALT水平与CD86^+pDC%、CD86MFI和CD86抗体结合量(antibody binding capacity,ABC)相关性无统计学意义。结论pDC频数与CHB发病相关。CHB患者pDC频数越低越容易发生肝炎。因此,提高pDC频数可能抑制肝炎的发生。Objective To investigate the association between the pathogenesis of hepatitis B e antigen(HBeAg)-positive chronic hepatitis B and the frequency and function of plasmacytoid dendritic cell(pDC)in patients HBeAg-positive chronic hepatitis B virus infection.Methods A total of 49 HBeAg(+)patients with chronic hepatitis B virus infection in immune tolerance phase(IT)and 100 patients in immune clearance phase(IC)were enrolled.The viral serological indicators and liver function were detected.Peripheral venous blood samples were collected.The peripheral blood pDC frequency and the quantitative expression of co-stimulatory molecule CD86 were detected by flow cytometry,and the correlation between the onset of chronic hepatitis B and the frequency and function of pDC was analyzed.Results In IC group,hepatitis B surface antigen(HBsAg)levels,HBeAg levels and hepatitis B virus(HBV)DNA loads were significantly lower than those in IT group,and alanine aminotransferase(ALT)levels in IC group were significantly higher than that in IT group;pDC%in IC group was significantly lower than that in IT group;CD86^+pDC%and CD86 mean fluorescentintensity(MFI)showed no significant difference between the two groups.In the IC group,the baseline pDC%was negatively correlated with ALT levels,while CD86^+pDC%,CD86MFI,and CD86 antibody binding capacity(ABC)had no remarkable correlation with ALT levels.Conclusions The frequency of pDC was correlated with the pathogenesis of CHB.The lower the frequency of pDC in patients with CHB,the more prone to hepatitis.Therefore,increasing the frequency of pDC may inhibit the occurrence of hepatitis.

关 键 词：浆细胞样树突状细胞 慢性乙型肝炎 乙型肝炎病毒 

分 类 号：R512.62[医药卫生—内科学]