接受索磷布韦/维帕他韦治疗的慢性丙型肝炎患者免疫检查点TIM-3、PD-1表达情况及临床意义  

Expression of TIM-3 and PD-1 at immune checkpoint in patients with chronic hepatitis C treated with sophobuvir/Vipartamivir and its clinical significance

作　　者：童毅 胡素侠[2] 王然 戴京京 TONG Yi;HU Su-xia;WANG Ran;DAI Jing-jing(Department of Laboratory,Huai'an First Hospital Affiliated to Nanjing Medical University,Jiangsu 223300,China;Department of Laboratory,the First Affiliated Hospital of Anhui University of Technology(the first People's Hospital of Huainan),Anhui 232000,China)

机构地区：[1]南京医科大学附属淮安第一医院检验科,江苏223300 [2]安徽理工大学第一附属医院(淮南市第一人民医院)检验科,安徽232000

出　　处：《肝脏》2023年第12期1455-1458,共4页Chinese Hepatology

基　　金：安徽省教育厅2021年高等学校省级质量工程项目(2021jyxm0386)。

摘　　要：目的观察接受索磷布韦维帕他韦治疗的慢性丙型肝炎(CHC)患者免疫检查点T细胞免疫球蛋白黏蛋白3(TIM-3)、程序性细胞死亡受体-1(PD-1)的表达及临床价值。方法选择2020年8月—2022年8月南京医科大学附属淮安第一医院收治的120例CHC患者作为CHC组,另选取同期于本院体检的118例研究对象,将其作为健康对照组,CHC组给予CHC组患者索磷布韦/维帕他韦治疗,连续治疗3个月。比较两组血生化指标、单核亚群细胞以及各亚群TIM-3、PD-1水平进行检测。结果未进行治疗时,CHC患者血清ALT、AST水平分别为[(74.0±35.8)U/L、(55.1±26.0)U/L]相较于健康对照组[(14.9±6.3)U/L、(19.2±7.0)U/L]显著升高;在治疗3个月末,CHC患者PD-1 CD4、PD-1 CD8、TIM-3 CD8、TIM-3 CD4水平分别为[(0.6±0.1)%、(1.7±0.6)%、(2.5±1.0)%、(6.5±1.0)%]比对照组[(0.4±0.1)%、(1.5±0.7)%、(1.7±0.8)%、(6.0±2.4)%]高(均P<0.05)。结论索磷布韦/维帕他韦治疗CHC,有助于患者肝功能的改善,而CHC患者存在外周血部分淋巴细胞比例紊乱,负性免疫检查点分子的高表达可对细胞免疫进行调控,对于单药治疗未见症状改善的患者,可在应用索磷布韦治疗的基础上加用维帕他韦治疗。Objective To investigate the expression and clinical significance of immunoglobulin mucin 3(TIM-3)and programmed cell death receptor-1(PD-1)in immune checkpoint T cells of chronic hepatitis C(CHC)patients treated with sofosbuvir/velpatasvir.Methods Between August 2020 and August 2022,120 patients with CHC in Huai'an First Hospital Affiliated to Nanjing Medical University were selected as the CHC group,while 118 healthy individuals who underwent physical examination in the same period were selected as the healthy control group.The CHC group was treated with sofosbuvir/velpatasvir for 3 months.Blood biochemical indexes,monocyte subsets,and the levels of TIM-3 and PD-1 in each subgroup were compared between the two groups.Results In the absence of treatment,serum ALT and AST levels in CHC patients[(74.0±35.8)U/L,(55.1±26.0)U/L]were higher than those in healthy control group[(14.9±6.3)U/L,(19.2±7.0)U/L].After three months of treatment,the PD-1 CD4,PD-1 CD8,TIM-3 CD8,TIM-3 CD4 in CHC patients[(0.6±0.1)%,(1.7±0.6)%,(2.5±1.0)%,(6.5±1.0)%,respectively]were higher than those in the healthy control group[(0.4±0.1)%,(1.5±0.7)%,(1.7±0.8)%,(6.0±2.4)%](P<0.05).Conclusion Therapy with sophobuvir/velpatasvir can significantly improve liver function in CHC patients.The peripheral blood lymphocyte ratio is disturbed in CHC patients,and the high expression of negative immune checkpoint molecules has been observed to regulate cellular immunity.For patients who do not experience symptom improvement with single drug therapy,the addition of sofosbuvir to velpatasvir therapy may be a potential consideration.

关 键 词：慢性丙型肝炎 索磷布韦 维帕他韦 T细胞免疫球蛋白黏蛋白3 程序性细胞死亡受体-1 

分 类 号：R512.63[医药卫生—内科学]