慢性HBV感染非活动性表面抗原携带者免疫状态  

Immune status of inactive HBsAg antigen carriers with chronic HBV infection

作　　者：王晓晓 任姗[1] 郑素军[1] 陈新月[1] Wang Xiaoxiao;Ren Shan;Zheng Sujun;Chen Xinyue(Department I of Liver Disease Center,Beijing You'an Hospital,Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学附属北京佑安医院肝病中心一科,北京100069

出　　处：《中华肝脏病杂志》2024年第S2期54-62,共9页Chinese Journal of Hepatology

基　　金：科技部国家重点研发计划(2023YFC2308100);北京市自然科学基金面上项目(7232080);北京市卫生健康委员会高层次公共卫生技术人才建设项目(学科带头人-02-14);北京市科委首都临床诊疗技术研究及转化应用(Z211100002921059);首都临床特色诊疗技术研究及转化应用(Z221100007422063);首都卫生发展科研专项重点攻关(2022-1-2172)

摘　　要：慢性乙型肝炎病毒(HBV)感染的非活动性乙型肝炎表面抗原(HBsAg)携带者(IHC)处于免疫控制期(IC),其特征为乙型肝炎e抗原阴性、丙氨酸转氨酶正常、HBV DNA低水平或不可检测以及HBsAg水平低于1000 IU/ml。此阶段宿主的固有免疫和适应性免疫应答得到改善,病毒逃逸能力下降。IC期患者的肝内免疫基因和代谢相关基因表达上调,包括模式识别受体、抗病毒效应因子和干扰素途径。此外,固有免疫如树突状细胞、自然杀伤细胞和巨噬细胞的功能在IC期得到恢复,而在适应性免疫中,HBV特异性T淋巴细胞和B淋巴细胞的功能耗竭减弱,部分功能重建。这些免疫学特征与免疫耐受期和免疫活动期患者的差异存在统计学意义,表明IHC患者可能成为实现乙型肝炎临床治愈的优势人群。Hepatitis B e antigen-negative,normal alanine aminotransferase,low or undetectable HBV DNA,and HBsAg levels below 1000 IU/ml are characteristics of the immune control stage(IC)in inactive hepatitis B surface antigen(IHC)carriers with chronic hepatitis B virus(HBV)infection.This stage improves the host's innate and adaptive immune responses,thereby reducing the ability for viral evasion.The expression of intrahepatic immune genes and metabolism-related genes,including pattern recognition receptors,antiviral effector factors,and interferon pathways,is upregulated in patients at this stage.The functions of innate immunity are also restored,including those of dendritic cells,natural killer cells,and macrophages during the IC stage,while in adaptive immunity,the exhaustion and partial functional reconstruction of HBV-specific T lymphocytes and B lymphocytes are weakened.These suggest that patients in the IHC stage may become an advantageous population for achieving clinical cure of hepatitis B due to their immunological characteristics,which differ statistically from those of patients in the immune tolerance and immune active stages.

关 键 词：慢性乙型肝炎 固有免疫 适应性免疫 非活动性HBSAG携带者 免疫控制期 

分 类 号：R51[医药卫生—内科学]