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2010年2月28日:树突细胞治疗有望降低乙肝病毒。
2010年2月28日:树突细胞治疗有望降低乙肝病毒。
四男性乙肝病人,30到60岁,常用治疗无效,受试树突细胞治疗,一个月后HBVDNA和ALT均降,2个病人HBVDNA转阴。
Dendritic Cell Treatment Shows Promise for Decreasing Viral Loads in Chronic Hepatitis B: Presented at AAAAI
By Carole VanSickle Ellis
NEW ORLEANS -- February 28, 2010 -- Physician's treating patients with chronic hepatitis B virus (cHBV) may be able to turn a decade's worth of cancer research to their advantage when it comes to using dendritic cells (DCs) in immune therapy protocols for these patients, researchers said here on February 27 at the 2010 American Academy of Allergy, Asthma & Immunology (AAAAI) Annual Meeting.
According to Leonid Titov, MD, Research Institute for Epidemiology and Microbiology, Minsk, Belarus, and colleagues, since patients with cHBV have impaired dendritic cell function, their immune systems are not able to produce mature DCs.
However, a new maturation protocol being investigated for safety and efficacy at the Research Institute for Epidemiology and Microbiology, allows for a new form of DC therapy similar to conventional DC-based cancer therapies, for patients with cHBV.
The 4 patients were male, aged 30 to 60 years, and had polymerase chain reaction-proven cHBV for several years. They had been unsuccessfully treated using standard protocols. Using peripheral blood taken from the patients, DCs were prepared and then injected into the forearms of the patients. Once injected, the patients were monitored for 7 days and then discharged from the hospital. The other 2 injections were performed in the outpatient department at 3-week intervals.
The number of DCs generated from 50 mL of blood was limited by the number of circulating monocytes and the efficiency of isolation procedures. The cultures were tested for sterility twice and were found free of microbial contaminants.
All of the patients tolerated the injections well, and no local or systemic side effects were observed. All patients also demonstrated a clinical response to therapy, typified by a significant decrease in viral load and alanine aminotransferase levels 1 month after the DC injections.
Three of the 4 patients had an increase in CD4/CD8 index and CD3-CD16+, and CD3-CD56+ cell count. These patients also showed elevated expression of CD28 by T cells after the treatment. One month after the study, HBV viral load was undetectable in 2 of the 4 patients. The other 2 showed a significant reduction.
The study indicated that there are no adverse effects of DC-based treatment of patients with cHBV. In addition, short-term clinical efficacy of DC-based immunotherapy was evident in all 4 patients.
The authors noted that advanced, multicentre trials will be needed to allow for longer observation of patients in order to prove the sustained impact of the treatment.
It should be noted that the same DC generation method could be implemented to obtain antigen-specific DC from patients' blood with hepatitis C. These cells can be loaded with hepatitis C virus nonstructural proteins to aid in immune-based cellular therapy.
[Presentation title: Safety and Short Term Efficacy of Dendritic Cell Immune Therapy in Patients With Chronic Hepatitis B. Abstract 50] |
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