自身免疫性肝病相关抗体与CD4^＋4CD25^＋high调节性T细胞的临床意义探讨

目的探讨自身免疫性肝炎（AIH）患者外周血CD_4^＋CD_25^＋high调节性T细胞的作用。方法抗核抗体酶联免疫分析法检测（ANA）。自身免疫性肝病谱线性免疫分析法（LIVER-LIA）测定抗肝肾微粒体1（LKM-1）、抗肝细胞溶质抗原1（LC-1）、抗线粒体-2（AMA-M2）、抗可溶性肝抗原／抗肝胰抗原（SLA／LP）。用流式细胞仪技术比较分析AIH患者51例、慢性乙型肝炎（CHB）30例及健康正常人20例外周血中的CD_4^＋CD25^＋high调节性T细胞，用免疫组织化学法检测AIH和CHB患者肝组织Foxp3的表达情况。结果AIH占51％（51／100），AIH组外周血中CD4^＋CD25^＋high／CD4^＋百分率显著低于正常组（P〈0．05）和CHB组（P〈0．01），并且CHB组显著高于正常组（P〈0．05）；同时AIH组外周血中CD_4^＋T细胞也显著高于CHB组（P〈0．01）；肝组织Foxp3^＋细胞主要分布于肝小叶内窦周隙、汇管区，AIH组肝组织Foxp3^＋表达显著低于CHB组（P〈0．01）。结论CD4^＋CD25^＋high调节性T细胞下降可能是自身免疫性肝炎发病的原因之一。

Study of CD4+ CD25+high regulatory T cells in patients with autoimmune hepatitis

Objective To investigate the role of CD_4^＋ CD_25^＋high regulatory T cells in the pathogenesis of autoimmune hepatitis. Methods ELISA for the Detection of Antinuclear Antibodies （ANA）. Line Immuno As-say （LIA） for the Detection of Autoantibodies in Autoimmune Liver Diseases （LKM-1, LC-1, AMA-M2, SLA/ LP）. CD_4^＋ CD_25^＋high regulatory T cells and CD_4^＋ T cells were measured by using flow cytometry in 51 patients with autoimmune hepatitis,30 patients with chronic hepatitis B and 20 healthy blood donors. Foxp3 protein were detected by inImmunohistochemistry assay in liver tissues from those patients with autoimmune hepatitis or chronic hepatitis B. Results The percentage of CD_4^＋ CD_25^＋high/CD_4^＋ in patients with autoimmune hepatitis were signifi- cantly lower than those in healthy controls and patients with chronic hepatitis B. Meanwhile, the percentage of CD_4^＋ CD_25^＋high/CD_4^＋ highly increased in patients with chronic hepatitis B ,compared with healthy controls; Foxp3 positive cells were most located in the lobulose perisinussoidal and the portal tract, and there was a significant difference in the quantity of Foxp3 positive cells between patients with autoimmune hepatitis and chronic hepatitis B. Conclusion Patients with autoimmune hepatitis barber an decreased percentage of CD_4^＋ CD_25^＋high regulatory T cells,which may be associated with development of autoimmunity.