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Th17/Treg平衡在乙型肝炎重症化过程中的作用及临床意义

Role and clinical significance of Th17/Treg balance in patients with severe exacerbation of hepatitis B

摘要:

目的 探讨Th17/Treg平衡在乙型肝炎重症化免疫机制中的作用. 方法 收集慢性乙型肝炎患者41例资料,根据观察患者住院期间病情有无进展为重型肝炎,分为病情加重组(19例)和病情改善组(22例).在人院时、治疗1周、治疗2周和治疗终点4个不同时间点分别用流式细胞术测定研究对象外周血中的Th17、Treg细胞频数,用酶联免疫吸附试验(ELISA)检测患者血清中白细胞介素(IL)-17、IL-10、转化生长因子β的水平,并比较病情加重组和病情改善组中Th17、Treg的细胞频数的动态变化,分析其与肝炎临床指标和细胞因子的相关性.组间比较用f检验,组内不同时间点比较用单因素方差分析,相关性分析用Person检验. 结果 (1)随着病情进展,病情加重组Th17细胞频数增高,而Treg细胞频数持续处于较低水平,而病情改善组则与之相反;病情加重组患者外周血Th17细胞频数高于病情改善组,而Treg细胞低于病情改善组;(2) Th17/Treg比值随着疾病进展向着相反的方向变化,随着病情加重逐渐升高,病情好转时下降;在病情加重组和病情改善组中,Th 17/Treg比值与总胆红素呈正相关,与凝血酶原活动度呈负相关;(3)在病情加重组和病情改善组中Th17细胞与IL-17呈正相关,Treg细胞与IL-10、转化生长因子β均呈正相关.结论 Th17和Treg细胞在乙型肝炎重症化过程中起着重要作用,Th 17/Treg的比值可能作为判断乙型肝炎重症化过程中病情严重程度的免疫生物学标志物.

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abstracts:

Objective To investigate the role of Th17/Treg balance in immune mechanism in severe exacerbation of hepatitis B.Methods The clinical data of 41 patients with chronic hepatitis B were collected,and according to the conditions during hospitalization,these patients were divided into exacerbation group (19 patients) and improvement group (22 patients).On admission,at weeks 1 and 2 of treatment,and at the end of treatment,flow cytometry was used to measure the frequencies of Th 17 and Treg cells in peripheral blood,and enzyme-linked immunosorbent assay was used to determine the serum levels of interleukin-17 (IL-17),interleukin-10 (IL-10),and transforming growth factor-β (TGF-β).The dynamic changes in the frequencies of Th17 and Treg cells were compared between the two groups,and the correlation between clinical indices for hepatitis and cytokines was analyzed.The t-test was used for comparison between groups,a one-way analysis of variance was used for comparison within one group across different time points,and Pearson correlation analysis was performed.Results With disease progression,the exacerbation group showed an increase in the frequency of Th 17 cells and a relatively low frequency of Treg cells;compared with the improvement group,the exacerbation group had a higher frequency of Th 17 cells and a lower frequency of Treg cells.Th1 7/Treg ratio gradually increased with exacerbation and decreased with improvement in conditions;in the exacerbation group and the improvement group,Th17/Treg ratio was positively correlated with total bilirubin and negatively correlated with prothrombin activity.In the exacerbation group and the improvement group,Th 17 cells were positively correlated with IL-17,and Treg cells were positively correlated with IL-10 and TGF-β.Conclusion Th1 7 and Treg cells play important roles in severe exacerbation of hepatitis B,and Th1 7/Treg ratio may be used as an immunobiological marker for the judgment of severity during severe exacerbation of hepatitis B.

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作者: 郭声 [1] 程娜 [2] 葛善飞 [2] 袁松松 [2] 邬小萍 [2] 向天新 [2] 周观林 [3]
期刊: 《中华肝脏病杂志》2016年24卷5期 341-346页 MEDLINEISTICPKUCSCD
栏目名称: 病毒性肝炎
DOI: 10.3760/cma.j.issn.1007-3418.2016.05.006
发布时间: 2016-07-26
基金项目:
江西省教育厅科学技术研究项目(28390896)Science and Technology Project Founded by the Education Department of Jiangxi Province
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