慢性乙型肝炎伴肝损伤和HBsAg丢失的长期核苷类似物治疗停止

StephenW

Increased NK Cell Function after Cessation of Long-Term Nucleos(t)ide Analogue Treatment in Chronic Hepatitis B Associates with Liver Damage and HBsAg Loss
Christine L Zimmer Franziska Rinker Christoph Höner zu Siederdissen Michael P Manns Heiner Wedemeyer Markus Cornberg Niklas K Björkström
The Journal of Infectious Diseases, jiy097, https://doi.org/10.1093/infdis/jiy097
Published:
17 February 2018
Article history
Received:
04 August 2017

Abstract
Background

Treatment with nucleos(t)ide analogues (NA) efficiently suppress HBV DNA but rarely leads to functional cure of chronic hepatitis B (CHB). Following NA cessation, a fraction of HBeAg-negative CHB-patients experience HBsAg loss. Cellular immune responses, including those by natural killer cells, innate lymphocytes known to respond in CHB, explaining the virological events transpiring following NA treatment cessation remain elusive.
Methods

In a single-center prospective trial, 15 HBeAg-negative CHB-patients on long-term NA treatment underwent structured NA cessation and were studied longitudinally. The NK cell compartment was assessed using high-dimensional flow cytometry and correlated with the clinical course.
Results

Unsupervised stochastic neighbor embedding analysis revealed NA treated CHB-patients to have a significantly affected NK cell compartment as compared to controls. Cessation of NA treatment resulted in only minor phenotypic alterations, but it significantly augmented NK cell natural cytotoxicity responses in the CHB-patients. This increased NK cell functionality correlated with ALT flares experienced by the patients and was particularly enhanced in patients experiencing HBsAg seroclearance at long-term follow-up.
Conclusions

Increased NK cell function associates with active hepatitis and HBsAg seroclearance following structured NA cessation. This adds to our knowledge of the immunological events that develop following cessation of NA treatment in CHB.

StephenW

慢性乙型肝炎伴肝损伤和HBsAg丢失的长期核苷类似物治疗停止后NK细胞功能增加
Christine L Zimmer Franziska Rinker ChristophHönerzu Siederdissen Michael P Manns Heiner Wedemeyer Markus Cornberg Niklas KBjörkström
“传染病杂志”，jiy097，https://doi.org/10.1093/infdis/jiy097
发布时间：
2018年2月17日
文章历史
收稿日期：
2017年8月4日


抽象
背景

NA停止后，一部分HBeAg阴性慢性乙型肝炎患者经历HBsAg消失。细胞免疫应答，包括天然杀伤细胞的那些，已知在CHB中响应的先天淋巴细胞，解释NA治疗停止后发生的病毒学事件仍然难以捉摸。
方法

在一项单中心前瞻性试验中，15名长期NA治疗的HBeAg阴性慢性乙型肝炎患者接受了结构化NA的戒断，并进行了纵向研究。使用高维流式细胞术评估NK细胞区室并且与临床过程相关。
结果

无监督随机邻居嵌入分析显示与对照相比，NA治疗的CHB患者具有显着影响的NK细胞区室。 NA治疗的停止仅导致轻微的小型表型改变，但其显着增强了CHB-患者中的NK细胞天然细胞毒性反应。这种增加的NK细胞功能与患者经历的ALT耀斑相关，并且在长期随访中经历HBsAg血清清除的患者中特别增强。
结论

增加的NK细胞功能与活动性肝炎和HBsAg血清学清除后的结构性NA无关。这增加了我们对在CHB中停止NA治疗后发生的免疫事件的了解。

Espoir

Increased NK cell function associates with active hepatitis，and HBsAg seroclearance following structured NA cessation. This adds to our knowledge of the immunological events that develop following cessation of NA treatment in CHB.

增加的NK细胞功能与活动性肝炎，以及结构化NA停止后的HBsAg血清学清除有关。 这增加了我们对在CHB中停止NA治疗后发生的免疫事件的了解。

antiHBVren

回复 Espoir 的帖子

这也能说明，为啥302医院招募HBeAg阴性结构化停药的研究啦

jdcy

有没有关于乙肝大三阳的研究？

antiHBVren

回复 jdcy 的帖子

大三先变成小三吧；
记得之前激进治疗建议：小于30岁的没有发病大三可以不治；其他情况治疗有助于降低HCC

jdcy

antiHBVren 发表于 2018-2-26 21:31
回复 jdcy 的帖子

大三先变成小三吧；

你的意思、我目前的情况应该立即吃药治疗？

antiHBVren

回复 jdcy 的帖子

治病，请看大夫的意见；
这里只讨论HBV的学术研究；

另外，概率统计和个人还是存在差异的

jdcy

antiHBVren 发表于 2018-2-28 15:28
回复 jdcy 的帖子

治病，请看大夫的意见；

请看5楼、我问的是有没有关于乙肝大三阳的研究？是您先给我治疗建议的、我就接着问、您就叫我去看大夫、我能讲什么、