评估慢性乙型肝炎T细胞免疫力和预测早期抗病毒治疗有效性

StephenW

An Immuno-Clinic score model for evaluating T cell immunity and predicting early antiviral therapy effectiveness in chronic hepatitis B
Yurong Gu  1 , Xiaoyan Li  1 , Lin Gu  2 , Yifan Lian  2 , Ke Wang  1 , Youming Chen  1 , Jing Lai  1 , Yongyu Mei  1 , Jing Liu  1 , Zexuan Huang  2 , Min Zhang  1 , Lubiao Chen  1 , Yuehua Huang  1   2
Affiliations
Affiliations

    1
    Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China.
    2
    Guangdong Provincial Key Laboratory of Liver Disease Research, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China.

    PMID: 33401245 DOI: 10.18632/aging.202274

Abstract

We generated an Immuno-Clinic score (ICS) model to evaluate T cell immunity based on the clustering of antiviral cytokines and inhibitory molecules in 229 naïve chronic hepatitis B (CHB) patients. 126 patients receiving antiviral therapy were used to validate the model for predicting antiviral therapy effectiveness. Through receiver-operator characteristic curve analysis, the area under the curve, sensitivity, and specificity of the ICS model were 0.801 (95%CI 0.703-0.900), 0.727, and 0.722, respectively. The cut-off value was 0.442. Re-evaluation of T cell immunity in different phases of CHB showed that patients in the immune tolerant phase had the lowest percentage of ICS-high (15%), while patients in the inactive carrier phase had the highest percentage of ICS-high (92%). Patients in the immune active and gray zone phases had 17% and 56% ICS-high, respectively. Elevation of ICS as early as four weeks after treatment could predict the effectiveness of hepatitis B virus (HBV) DNA loss and normalization of alanine aminotransferase, while eight weeks after treatment could predict HBV surface antigen decline. Thus, this ICS model helps clinicians choose an optimal time for initiating antiviral therapy and predicting its efficacy.

Keywords: Immuno-Clinic score (ICS); T-cell; chronic hepatitis B (CHB); cytokines; hepatitis B virus (HBV).

StephenW

评估慢性乙型肝炎T细胞免疫力和预测早期抗病毒治疗有效性的免疫-临床评分模型
顾玉荣1，李晓燕1，古琳2，连一凡2，王珂1，陈有明1，赖敬1，雍玉梅1，刘静1，黄宣萱2，张敏1，陈鲁标1，黄月华1 2
隶属关系
隶属关系

    1个
    中山大学附属第三医院感染科，广东广州510630
    2
    中山大学附属第三医院广东省肝病研究重点实验室，广州510630

    PMID：33401245 DOI：10.18632 / aging.202274

抽象

我们基于229名单纯性慢性乙型肝炎（CHB）患者的抗病毒细胞因子和抑制分子的聚类，生成了一个免疫临床评分（ICS）模型来评估T细胞免疫。 126名接受抗病毒治疗的患者用于验证预测抗病毒治疗效果的模型。通过操作者特征曲线分析，ICS模型的曲线下面积，灵敏度和特异性分别为0.801（95％CI 0.703-0.900），0.727和0.722。截止值为0.442。对CHB不同阶段中T细胞免疫的重新评估表明，处于免疫耐受阶段的患者ICS-high的百分比最低（15％），而处于非活动性携带期的患者ICS-high的百分比最高（92） ％）。处于免疫活动期和灰色区期的患者的ICS高分别为17％和56％。治疗后4周，ICS升高可预测乙型肝炎病毒（HBV）DNA丢失和丙氨酸转氨酶正常化的有效性，而治疗后8周可预测HBV表面抗原下降。因此，该ICS模型可帮助临床医生选择最佳时间开始抗病毒治疗并预测其疗效。

关键字：免疫临床评分（ICS）； T细胞慢性乙型肝炎（CHB）；细胞因子乙型肝炎病毒（HBV）。