恩替卡韦治疗慢性乙型肝炎患者免疫功能变化的研究

目的 研究恩替卡韦(ETV)治疗慢性乙型肝炎过程中患者免疫功能的变化.方法 在应用ETV治疗的不同时间点抽取HBV感染患者及健康对照者静脉血.对HBV表面标志物、HBV DNA、ALT水平进行检测;分离血清及外周血单核细胞(PMBC),检测并对比治疗前后血清细胞因子、经CD3/CD28细胞和HBV核心抗原(HBcAg)...

Study of immune function change in chronic hepatitis B patients with enticarvir antiviral treatment

Objective To investigate the feature of immune function in chronic hepatitis B(CHB) patients with enticarvir (ETV) therapy. Methods The venous blood samples in health controls and CHB patients at different time points after ETV therapy were collected. Serum and PBMCs were isolated, HBV markers, HBV DNA, ALT, serum cytokines and the cytokines were stimulated by CD3/CD28 cells and HBcAg, the frequency of immune cells were detected and compared with pretreatment. Results ALT and HBV DNA levels in patients at the 4th week decreased significantly, which were (73.78 ±93.34) U/L and (3.98 ±0.75)IU/mL respectively (t =3.816,2.795, P< 0.05), and the both returned to normal after 48-week therapy of ETV. IFN γ in serum and two stimulation supernatant decreased significantly compared to baseline after 4-week therapy (t - 2.386,2.358,2.448, P < 0.05). IL-10 level in serum decreased to (78.12 ± 24.01) pg/mL and was still higher than that in the health controls at the 48th week( t = 2.823, P < 0.05). IL-17 in serum and two stimulation supernatant increased significantly compared to baseline at the 4th week (t = 3.580, 2.448,2.464, P<0.05). IL-22 in serum increased to (85.22± 38.37) pg/mL and was still lower than that in health controls at the 4th week 0 = 2.272, p<0.05).The frequency of Th1 and Th17 cells increased significantly at the 4th week (t = 2.386, 2.998, P < 0.05); and then decreased gradually but still higher than that in health controls at the 48th week. The frequency of Th2 cells increased obviously at the 4th week (t = 3.062,P<0.05), and was the highest at the 12th week, then was lower than that in health controls at the 48th week( t = 2.690, P < 0.05) .The frequency of Treg cells decreased to normal after the treatment. Conclusions ETV suppresses HBV replication efficiently, which may attenuate hepatic inflammation but impair the ability of HBV clearing in the disease.