妊娠期、产后和育龄未孕期慢性HBV感染者间HBV特异性T细胞反应活性比较  

Comparison of HBV-specific T cell reactivity among pregnant, postpartum and non-pregnant women at childbearing age with chronic HBV infection

作　　者：王根菊[1] 吴燕丹 纪瑞雪 岳芳平 江红秀[1] Wang Genju;Wu Yandan;Ji Ruixue;Yue Fangping;Jiang Hongxiu(Department of Obstetrics and Gynecology,Nanjing Second Hospital,Nanjing 210003,China;Department of Microbiology and Immunology,Medical School of Southeast University,Nanjing 210009,China)

机构地区：[1]南京市第二医院妇产科,南京210003 [2]东南大学医学院病原生物学与免疫学系,南京210009

出　　处：《中华微生物学和免疫学杂志》2024年第9期784-791,共8页Chinese Journal of Microbiology and Immunology

摘　　要：目的探讨妊娠期、产后以及育龄未孕期慢性HBV感染患者HBV特异性T细胞反应活性的特征。方法选取100例慢性HBV感染患者,其中妊娠组43例,产后6个月内组26例,育龄未孕组31例,ELISPOT系统检测患者外周血HBV特异性T细胞的反应活性,同时收集临床资料和HBV病毒学及血清学常规检测数据进行分层分析。结果妊娠组感染者的HBV特异性T细胞反应活性与产后组的差异无统计学意义,但明显低于育龄未孕组(P<0.05)。接受核苷类似物治疗的妊娠组感染者HBV特异性T细胞反应活性明显高于未治疗的妊娠组(P<0.05)。未经核苷类似物治疗的患者中,妊娠组HBV包膜抗原和核心抗原(HBeAg/HBcAg)特异性T细胞反应活性与产后组的差异无统计学意义,但明显低于育龄未孕组(P<0.05)。经核苷类似物治疗的患者中,妊娠组HBV特异性T细胞反应活性与育龄未孕组的差异无统计学意义,但是妊娠组和育龄未孕组都明显高于产后组(P<0.05)。受试者工作特征曲线显示,HBV特异性T细胞指标与HBV DNA载量[曲线下面积(AUC)=(0.807)]或HBV表面抗原(HBsAg)水平(AUC=0.916)联合时,对妊娠期患者的肝炎进展具有良好的预测效能。结论妊娠导致慢性HBV感染者体内HBV特异性T细胞反应活性降低,但能被核苷类似物治疗所改善。妊娠期以及产后定期监测HBV特异性T细胞反应活性能为患者免疫功能评价和治疗提供有价值的指导。ObjectiveTo investigate the characteristics of HBV-specific T cell reactivity among pregnant,postpartum and non-pregnant women at childbearing age with chronic HBV infection.MethodsA total of 100 patients with chronic HBV infection were enrolled in this study,including 43 pregnant women(pregnant group),26 patients giving birth within six months(postpartum group),and 31 non-pregnant patients at childbearing age(non-pregnant group).The functional HBV-specific T cells in peripheral blood were detected by ELISPOT.Clinical data as well as the results of virological and serological tests of HBV were collected for stratified analysis.ResultsThere was no significant difference in the number of functional HBV-specific T cells between the pregnant group and the postpartum group,but the number was significantly lesser in the pregnant group than in the non-pregnant group(P<0.05).Furthermore,the number of functional HBV-specific T cells was significantly higher in the nucleoside analogues(NUCs)-treated pregnant women than in the NUCs-untreated pregnant women(P<0.05).Among the patients without NUCs treatment,there were no significant differences in the numbers of hepatitis B envelope antigen/hepatitis B core antigen(HBeAg/HBcAg)-specific T cells between the pregnant group and the postpartum group,but the numbers were lower in the pregnant group than in the non-pregnant group(P<0.05).Among the NUCs-treated patients,there was no significant difference in the number of functional HBV-specific T cells between the pregnant group and the non-pregnant group,and the numbers in the two groups were significantly higher than that in the postpartum group(both P<0.05).Additionally,receiver operating characteristic(ROC)curve indicated that the number of functional HBV-specific T cells in combination with HBV DNA load[area under the curve(AUC)=0.807]or hepatitis B surface antigen(HBsAg)levels(AUC=0.916)had a good predictive performance for hepatitis progression during pregnancy.ConclusionsPregnancy can reduce HBV-specific T cell reactivity i

关 键 词：慢性HBV感染 妊娠 抗原特异性T细胞 

分 类 号：R714.251[医药卫生—妇产科学]