乙肝病毒對不同ALT分期慢性乙肝患者T淋巴細胞及其亞群的影

StephenW

乙肝病毒對不同ALT分期慢性乙肝患者T淋巴細胞及其亞群的影響：HBV感染新概念ALT
高鵬1、羅延平2、林晨3、楊仲夏3、何強4、李俊峰4
隸屬關係
隸屬關係

    1
    蘭州大學第一醫院傳染病研究所，甘肅省蘭州 730000電子地址：[email protected]。
    2
    蘭州大學醫學院免疫學系，甘肅省蘭州730000
    3
    蘭州大學第一醫院感染科，甘肅省蘭州 730000
    4
    蘭州大學第一醫院傳染病研究所，甘肅省蘭州 730000

    PMID：34601330 DOI：10.1016/j.intimp.2021.108182










強調


•
本文首次比較分析了不同ALT條件下乙肝患者T淋巴細胞及其亞群免疫狀態的差異。


•
本文首次揭示了ALT大於或等於正常上限2倍時免疫狀態的變化以及抗病毒治療對免疫功能的影響。


•
本文首次提出了以ALT為節點判斷機體免疫功能的意義。





抽象

本研究旨在探討乙型肝炎病毒對不同ALT狀態下T淋巴細胞及其亞群的影響，闡明以ALT為基礎抗病毒治療乙型肝炎的免疫學機制。選取363例慢性乙型肝炎患者作為研究對象。科目。根據ALT異常，將患者分為三個研究組。 ALT正常組131例，正常≤ALT<上限2倍組110例，ALT≥上限2倍組122例。 ALT≥2次上限組患者給予恩替卡韋，隨訪24週。乙肝抗原抗體參數採用化學發光免疫分析儀測定，肝功能參數採用全自動生化分析儀測定，乙肝病毒載量採用定量PCR分析儀測定，T淋巴細胞採用流式細胞術檢測，IL-2水平, IFN-γ, IL-4 和 IL-10 通過酶聯免疫吸附試驗檢測。檢測不同人群乙肝病毒載量對免疫學指標的影響，以及抗病毒治療前後患者病毒學和免疫學指標的變化。在ALT正常組中，不同病毒載量的乙肝病毒對T淋巴細胞及其亞群影響較小（P>0.05）。 ALT≥正常組兩倍上限。隨著病毒載量的增加，T淋巴細胞總數、CD3+ CD4 + T淋巴細胞減少，（P < 0.05）CD3+ CD8 + T淋巴細胞增加（P < 0.05）。隨著病毒載量的增加，反映Th1淋巴細胞的細胞因子IL-2、IFN-γ增加（P < 0.05），反映Th2淋巴細胞的細胞因子IL-4、IL-10減少（P < 0.05）。恩替卡韋治療前後24週，患者HBV-DNA明顯下降（P < 0.05），機體免疫功能明顯改善。 (P < 0.05)不同ALT狀態下乙肝病毒對免疫功能的影響不同。因此，可以從免疫學角度闡明ALT分組在乙肝治療中的科學意義。

關鍵詞：慢性乙型肝炎； T淋巴細胞;病毒負載。

版權所有 © 2021 作者。由 Elsevier B.V. 出版。保留所有權利。

StephenW

The effect of hepatitis B virus on T lymphocyte and its subsets in chronic hepatitis B patients in different ALT stages: A new concept ALT in HBV infection
Peng Gao  1 , Yanping Luo  2 , Lin Chen  3 , Zhongxia Yang  3 , Qiang He  4 , Junfeng Li  4
Affiliations
Affiliations

    1
    The Research Institute of Infectious Diseases, The First Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, PR China. Electronic address: [email protected].
    2
    Department of Immunology, Medicine College of Lanzhou University, Lanzhou 730000, Gansu Province, PR China.
    3
    Department of Infectious Diseases, The First Hospital of Lanzhou University, Lanzhou, 730000 Gansu Province, PR China.
    4
    The Research Institute of Infectious Diseases, The First Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, PR China.

    PMID: 34601330 DOI: 10.1016/j.intimp.2021.108182
Highlights

•    This paper compares and analyzes the difference of immune status of T lymphocytes and their subsets in hepatitis B patients under different ALT conditions for the first time.
•    For the first time, this paper reveals the changes of immune status and the effects of antiviral therapy on immune function when ALT is greater than or equal to 2 times the normal upper limit.
•    This paper puts forward for the first time the significance of using ALT as a node to judge the immune function of the body.
Abstract

The aim of the present study was to explore the effect of hepatitis B virus on T lymphocyte and its subsets in different ALT states, and elucidate the immunological mechanism of ALT basing antiviral therapy for hepatitis B. 363 chronic hepatitis B patients were selected as the study subjects. According to ALT abnormalities, the patients were divided into three study groups. ALT normal group 131 cases, normal≦ ALT < 2 times of upper limit group 110 cases, ALT ≥ 2 times of upper limit group 122 cases. Entecavir was given to the ALT ≥ 2 times of upper limit group patients and followed up for 24 weeks. The hepatitis B antigen antibody parameters were measured by chemiluminescence immunoassay analyzer, the liver function parameters were measured by automatic biochemical analyzer, the hepatitis B virus load were measured by quantitative PCR analyzer, T lymphocytes were detected by flow cytometry, the level of IL-2, IFN-γ, IL-4 and IL-10 were detected by enzyme-linked immunosorbent assay. Detecting the influence of different hepatitis B viru loads in different groups on immunological indexes, and the virological and immunological indexes changes in before and after antiviral therapy patients. In the ALT normal group, different virus load hepatitis B virus had minor effect on T lymphocytes and their subsets (P > 0.05). In the ALT ≥ double upper limit of normal group. with the virus load increased, The total number of T lymphocytes, CD3+ CD4 + T lymphocytes decreased, (P < 0.05)CD3+ CD8 + T lymphocytes increased(P < 0.05). With the virus load increased the cytokines IL-2, IFN-γ which reflect the Th1 lymphocytes increased(P < 0.05), the cytokines IL-4、IL-10 which reflect the Th2 lymphocytes decreased(P < 0.05). Before and after 24 weeks of entecavir treatment, the patient's HBV-DNA decreased significantly(P < 0.05) and the body's immune function improved significantly. (P < 0.05)The influence of hepatitis B virus on immune function is different in different ALT states. Therefore, the scientific significance of ALT grouping in the hepatitis B treatment can be clarified from the immunological point.

Keywords: Chronic hepatitis B; T lymphocyte; Virus load.

Copyright © 2021 The Author(s). Published by Elsevier B.V. All rights reserved.

StephenW

https://www.sciencedirect.com/sc ... 21008183?via%3Dihub