IL-21参与HBeAg阳性慢性乙型肝炎的免疫发病机制的研究  

Study on the IL-21 participate in the immunopathogenesis of HBeAg-positive chronic hepatitis B

作　　者：蔡云 赵凯 潘良 周鑫 CAI Yun;ZHAO Kai;PAN Liang;ZHOU Xin(Department of Gastroenterology,the First People′s Hospital of Jintan,Jiangsu 213200,China)

机构地区：[1]金坛第一人民医院消化科,江苏213200

出　　处：《肝脏》2024年第4期436-439,共4页Chinese Hepatology

基　　金：常州市卫健委青年人才科技项目(QN202138)。

摘　　要：目的探讨白细胞介素21(Interleukin-21,IL-21)参与e抗原(hepatitis B e antigen,HBeAg)阳性慢性乙型肝炎(chronic hepatistis B,CHB)免疫病程的进展。方法入组2022年1月—2023年1月间由常州市金坛第一人民医院、镇江市第三人民医院诊治的HBeAg阳性CHB患者45例、CHB患者免疫耐受状态(immune tolerant,IT)20例、非活动表面抗原(hepatitis B s antigen,HBsAg)携带者(inactive carrier,IC)45例,在抗病毒治疗前及治疗48周后分别检测HBV血清标志物(HBeAg、HBsAg、Anti-HBs、Anti-HBe、Anti-HBc)、ALT、HBV DNA载量、IL-21浓度、IL-21^(+)CD4^(+)T细胞、IL-21R^(+)CD4^(+)T细胞频数。同时选取15例健康体检者检测相同指标作为对照。结果CHB和IC组患者的血清IL-21浓度[分别为(82.21±22.32)、(72.32±25.26)pg/mL]均显著高于HBeAg阳性免疫耐受患者[(20.24±15.56)pg/mL,P值均<0.001],IC组患者的IL-21^(+)CD4^(+)T细胞频数为(7.42±2.34)%、IL-21R^(+)CD4^(+)T细胞频数为(6.46±1.55)%,均显著高于CHB组(P值均<0.001)。血清ALT与IL-21浓度无相关性(r=0.136,P=0.20)。HBeAg阳性CHB患者抗病毒治疗后达到HBeAg血清学转换组治疗前外周血IL-21浓度为(92.58±25.76)pg/mL、IL-21^(+)CD4^(+)T细胞频数为(7.89±2.05)%、IL-21R^(+)CD4^(+)T细胞频数(7.01±1.51)%,均显著高于未达到HBeAg血清学转换组(P值均<0.01)。结论IL-21参与了HBeAg阳性CHB免疫病程的进展。Objective To investigate the involvement of Interleukin-21(IL-21)in the immune response of individuals with HBeAg positive chronic Hepatitis B(CHB).Methods 45 HBeAg-positive CHB patients,20 CHB patients in the immune tolerant(IT)phase,and 20 HBeAg-negative CHB patients in the inactive carrier(IC)phase were enrolled in this study.Levels of HBV serum markers,such as HBeAg,HBsAg,Anti-HBs、Anti-HBe、Anti-HBc,as well as ALT,HBV DNA levels,IL-21 cocentration,frequencies of IL-21^(+)CD4^(+)T cells,and frequencies of IL-21R^(+)CD4^(+)T cells were assessed before and after 48 weeks of antiviral therapy.Additionally,15 healthy volunteers were included as a control group and were assessed during the same period.Results The serum concentration of IL-21 in the CHB group(82.21±22.32 pg/mL)and IC groups(72.32±25.26 pg/mL)was significantly higher compared to IT group(20.24±15.56 pg/mL,P<0.001).The frequency of IL-21^(+)CD4^(+)T cells(7.42±2.34)%and IL-21R^(+)CD4^(+)T cells(6.46±1.55)%in the IC group was higher compared to the CHB group(P<0.001).No correlation was observed between serum ALT levels and IL-21 concentration(r=0.136,P=0.20).Furthermore,the IL-21 level(92.58±25.76 pg/mL),as well as the frequency of IL-21^(+)CD4^(+)T cells(7.89±2.05)%and IL-21R^(+)CD4^(+)T cells(7.01±1.51)%,were significantly higher in the peripheral blood of HBeAg-positive CHB patients who achieved HBeAg serologic conversion after antiviral therapy compared to those who did not(P<0.01).Conclusion IL-21 plays a significant role in the immunopathogenesis of HBeAg-positive chronic hepatitis B.

关 键 词：慢性乙型肝炎 白细胞介素-21 免疫 

分 类 号：R512.62[医药卫生—内科学]