Detection of T lymphocyte subsets and mIL-2R on surface of PBMC in patients with hepatitis B

AIM: To study the levels of T lymphocyte subsets andmembrane interleukin-2 receptor (mIL-2R) on surface ofperipheral blood mononuclear cells (PBMCs) of patients withhepatitis B and its role in the pathogenesis of hepatitis B.METHODS: The levels of T lymphocyte subsets and mIL-2R in PBMC before and after being stimulated with PHAwere detected by biotin-streptavidin (BSA) technique in 196cases of hepatitis B.RESULTS: In patients with hepatitis B, the levels of CD3+,CD4+ cells, and the ratio of CD4+ cells/CD8+ cells were lower,but the level of CD8+ cells was higher than those in normalcontrols (42.20±6.01 vs65.96±6.54, 38.17±5.93 vs41.73±6.40,0.91±0.28 vs 1.44±0.31, 39.86±6.36 vs30.02±-4.54, P＜0.01).The total expression level of mIL-2R in PBMC before andafter being stimulated with PHA was also lower than thosein normal controls (3.47±1.55 vs4.52±1.49, 34.03±2.94 vs37.95±3.00, P＜0.01). In all the patients with hepatitis B, thelevels of T lymphocyte subsets and mIL-2R in PBMC withHBV-DNA (+) were lower than those with HBV-DNA (-),which were significantly different (39.57±7.11 vs44.36±5.43,34.36±7.16 vs 40.75±5.87, 37.82±6.54 vs 41.72±6.21,0.88±0.33 vs0.99±0.27, 2.82±1.62 vs3.85±1.47, 31.56±3.00vs35.84±2.83, P＜0.01). In addition, the levels of CD3+, CD4+,CD8+ cells, the ratio of CD4+ cells/CD8+ cells and mIL-2R amongdifferent courses of hepatitis B were all significantly different(F=3 723.18, P＜0.01. F=130.43, P＜0.01. F=54.01, P＜0.01.F=2.99, P＜0.05. F=7.16, P＜0.01).CONCLUSION: Both cellular and humoral immune functionsare obviously in disorder in patients with hepatitis B, whichmight be closely associated with the chronicity in patients.     

mIL—2R,T cell subsets ＆ hepatitis C

AIM: To study the levels of membrane interleukin-2 receptor(mIL-2R ) and T cell subsets in peripheral bloodmononuclear cells (PBMC) from patients with hepatitis Cand their role in the pathogenesis of hepatitis C.METHODS: The levels of mlL-2R and T cells subsets in PBMCWere detected by biotin- streptstividin (BSA) technique beforeand after stimulation with PHA in 203 patients with hepatitis Cwith HCV-RNA( + ), anti-HCV( + ), anti-HCV(-).RESULTS: The total expressive levels of mlL-2R before andafter stimulation with PHA(0.03 ± 0.01, 0.03 ± 0.02, 0.04 ± 0.02, 0.36±0.03), and Tcell subsets in PBMC (0.62±0.06,0.37 ± 0.05, 0.35 ± 0.07) were all lower in patients withhepatitis C than those in normal controls (0.66 ± 0.07, 0.41± 0.06, 0.31 ± 0.05, P ＜ 0.01 ). Among the patients, thelevels of mlL-2R were lower in silence than those in situationof PHA inducting (P＜ 0.01). However, the levels of mlL-2Rwere similar in acute hepatitis C to that in chronic hepatitis C(P＞0.05). The levels of CD3+, CD4+, CD4 +/CD8+ Were lov erand CD8 + was higher in patients with acute and chronichepatitis C with anti-HCV( + ) than those in normal controls (0.62±0.06, 0.37±0.05, 0.35±0.07, 1.18±0.30, 0.61±0.07, 0.37±0.05, 1.39±0.33, 0.31±0.05, P＜0.05-P＜0.01).CONCLUSION: The cellular immunity is obviously changed inpatients with hepatitis C. The levels of mlL-2R end activationof T cells am closely associated with chronicity of hepatitis C.     

Effect of traditional Chinese medicinal enemas on ulcerative colitis of rats

AIM: To investigate the effects of traditional Chine semedicinal enema (TCME) on inflammatory and immune response of colonic mucosa of rats with ulcerative colitis(UC), and to observe the pathogenic mechanism.METHODS: Thirty UC rats, induced by intestinal enema together with 2.4-dinitrochlorobenzene (DNCB) and acetic acid, were randomly divided into 3 groups, i.e., GⅠ, GⅡ and GⅢ. Groups GⅠ and GⅡ were administered with TCME and salazosulfapyridine enema (SASPE), respectively. Group GⅢ was clystered with only normal saline (NSE), served as control. Group GIV was taken from normal rats as reference,once daily, from the 7th day after the establishment of UC for total 28 d. Interleukin-6 (IL-6) in the colonic mucosa was assayed by ^3H-TdR incorporation assay. Colonic mucosal lymphocyte subpopulation adhesive molecules, CD4^+CD11a^+,CD4^+CD18^+, CDs^+CD11a^+, CDs^+CD18^+ (LSAM), tumor necrosis factor (TNF)-α, and interferon-γ (IFN-γ), were detected by enzyme linked immunosorbent assay (ELISA). Moreover, the expression of TNF-α mRNA and IFN-γ mRNA in colonicmuc osa were detected by polymerase chain reaction (RT-PCR).RESULTS: Before therapies, in model groups, GⅠ, GⅡ and GⅢ,levels of IL-6, TNF-α, IFN-γ, CDs^+CD11a^+ and CD8^+CD18^+ were significantly different (38.29+2.61 U/mL, 16.54+1.23 ng/L,8.61+0.89 ng/L, 13.51+2.31% and 12.22+1.13% ,respectively) compared to those in GIV group (31.56+2.47 U/mL, 12.81+1.38 ng/L, 5.28+0.56 ng/L, 16.68+1.41% and 16.79+1.11%, respectively). After therapeutic enemas,in GI group, the contents of IL-6 (32.48±2.53 U/m), TNF-α(13.42±1.57 ng/L) and IFN-γ (5.87+0.84 ng/L) were reduced; then, the contents of CD8^+CD11a^+ (16.01+1.05 %)and CD8^+CD18^+ (16.28±0.19%) were raised. There was no significant difference between groups GⅠ and GIV, but the difference between groups GⅠ and GⅡ was quite obvious (P<0.05). The expressions of TNF-α mRNA and IFN-γ mRNAin group GⅢ were much higher than those of group GIV,but those in group GI were significantly suppressed by TCME therapy.CONCLUSION: Ulcerative colitis is related to colonic regional mucosal inflammatory factors and immune imbalance. TCME can effectively inhibit regional mucosal inflammatory factors and improve their disorder of immunity.     

外周血淋巴细胞亚群在慢性HBV感染过程中表达的变化分析

目的探讨HBV感染患者外周血淋巴细胞亚群在疾病进展过程中的表达变化。方法选取2018年1月-2019年4月在天津市第二人民医院住院的慢性HBV感染患者共132例,其中慢性乙型肝炎患者47例,乙型肝炎肝硬化患者44例,乙型肝炎肝硬化相关原发性肝癌患者41例。另选取同期健康体检者42例作为对照组。采用流式细胞术检测4组外周血淋巴细胞亚群精准计数,比较4组外周血淋巴细胞亚群的表达水平。正态分布的计量资料,组间方差不齐采用Welch方差分析,两两比较采用GamesHowell检验。非正态分布的计量资料多组间及进一步两两比较采用Kruskal-Wallis H检验。计数资料组间比较采用χ2检验。相关性分析采用Spearman检验。结果与对照组和慢性乙型肝炎组相比,肝硬化组和肝癌组CD3^+、CD4^+T淋巴细胞数量明显减少,差异均有统计学意义(P值均<0.05)。与对照组相比,肝癌组CD8^+T淋巴细胞数量明显减少,差异有统计学意义(P<0.05);与慢性乙型肝炎组相比,肝硬化组和肝癌组CD8^+T淋巴细胞数量明显减少,差异均有统计学意义(P值均<0.05)。与对照组和慢性乙型肝炎组相比,肝硬化组和肝癌组CD19^+B淋巴细胞数量明显减少,差异均有统计学意义(P值均<0.05)。与对照组相比,肝硬化组和肝癌组CD16^+CD56^+NK细胞数量明显减少,差异均有统计学意义(P值均<0.05);与慢性乙型肝炎组比较,肝癌组CD16^+CD56^+NK细胞数量明显减少,差异有统计学意义(P<0.05)。4组疾病进展与外周血CD3^+T淋巴细胞、CD4^+T淋巴细胞、CD8^+T淋巴细胞、CD19^+B淋巴细胞、CD16^+CD56^+NK细胞呈明显负相关(r值分别为-0.414、-0.503、-0.269、-0.435、-0.402,P值均<0.01)。结论随着疾病的进展,慢性HBV感染患者免疫状态发生变化。外周血淋巴细胞亚群精准计数能够反应机体的免疫状态,可作为慢性HBV感染临床病情演变、治疗效果及疾病预后的参考依据。     

rhG-CSF未经动员与动员后供者外周血淋巴细胞与干细胞采集物的细胞构成及功能比较

目的比较重组人粒细胞集落刺激因子（rhG-CSF）动员后供者外周血干细胞（PBSC）采集物与未经动员供者外周血淋巴细胞采集物的细胞构成及功能。方法取异基因造血干细胞移植供者的rhG-CSF动员后PBSC采集物（A组）和未经动员的淋巴细胞采集物（B组）,以流式细胞术测定采集物组分、T细胞亚群、树突细胞（DC）及其亚群、CD14^＋细胞和CD19^＋细胞B7分子的表达、CD4^＋T细胞IL-4和IFNγ等细胞因子的分泌情况,四甲基偶氮唑盐法测定T淋巴细胞增殖能力。结果两组采集物的CD3^＋、CD4^＋、CD34^＋、CD14^＋细胞比例有明显差异,A组DC细胞及其亚群的比例明显高于B组,尤以DC2升高为著（P=0．000）,CD14^＋细胞上B7分子的表达A组明显低于B组,CD19^＋细胞上B7分子的表达无明显差异,分析两组CD4细胞内因子的分泌情况,A组的Ⅱ类细胞因子IL-4及IL-4／IFNγ均明显高于B组（P值分别为0．044,0．012）,经rhG—CSF动员后采集物的T淋巴细胞增殖能力明显下降。结论动员后的PBSC采集物较未经动员的淋巴细胞采集物富集了更多的CD34^＋、CD14^＋细胞,同时rhG—CSF动员后DC2比例的明显升高使得CD4细胞向Th2分化,PBSC含有更多的Ⅱ类细胞因子和其T细胞增殖能力的下降、共刺激分子的下调均提示PBSC较供者淋巴细胞输注更少地引起急性移植物抗宿主病的发生。     

急性和慢性乙型肝炎患者外周血NK细胞和T淋巴细胞亚群的动态变化

目的：观察急性和慢性乙型肝炎患者急性期和恢复期外周血NK细胞和T淋巴细胞亚群的变化。方法在40例急性乙型肝炎和40例慢性乙型肝炎患者,分别在急性期和恢复期检测CD3＋CD4＋T细胞、CD3＋CD8＋T细胞和NK（CD3-CD16＋CD56＋）细胞占淋巴细胞的比率（%）。结果在急性乙型肝炎急性期NK细胞计数为（15.7±7.5）%,而在恢复期则上升至（21.9±8.2）%,（P＜0.05）;急性乙型肝炎患者在急性期CD3＋CD4＋T细胞为（35.5±6.8）%,到恢复期则显著下降（33.6±7.0）%,（P＜0.05）;急性乙型肝炎在急性期CD3＋CD8＋T细胞为（35.6±7.6）%,而在恢复期则显著下降（30.0±7.5）%,（P＜0.05）,后者仍比慢性乙型肝炎患者在病情恢复期高（19.1±7.1）%,（P＜0.05）。结论在急性乙型肝炎病程中,NK细胞呈上升趋势,CD3＋CD8＋T细胞呈下降趋势,而在慢性乙型肝炎患者NK细胞及T淋巴细胞数量下降,致病情迁延不愈。     

乙型肝炎病毒核心区基因变异与细胞免疫

目的 探讨慢性乙型肝炎患者乙型肝炎病毒(HBV)核心区Leu60Val变异与机体细胞免疫水平的关系。方法 通过流式细胞分析技术(FCM)检测外周血T淋巴细胞亚群,利用酶联免疫吸附试验(ELISA)检测血清细胞因子[干扰素γ(IFN-γ)、肿瘤坏死因子α(TNF-α)和白细胞介素2(IL-2)]水平,采用聚合酶链反应(PCR)扩增HBV DNA C基因区片段,并对PCR产物直接测序。结果 91例慢性乙型肝炎患者发生Leu60Val变异者19例,变异率为20.9％,随病情加重变异率逐渐增加,以重型肝炎组最高;Val60变异株组IFN-γ、TNF-α水平明显增高(t值分别为2.584、4.766,P<0.01),CD_4~1/CD_8~1比值逐渐升高(t=2.275,P<0.05)。结论 Val60变异株可能通过增加与Ⅰ类人白细胞抗原(HLA-Ⅰ)的亲和力,或上调HLA-Ⅰ类分子的表达,从而激活大量的细胞毒性T淋巴细胞释放细胞因子,并同时在肝脏局部发挥免疫效应,提高对宿主的杀伤力。     

糖皮质激素治疗重症急性呼吸综合征初探

目的　探讨糖皮质激素对重症急性呼吸综合征 (SARS)病情的影响。方法　定期观察我院自 2 0 0 3年 3月 2 6日至 5月初收治的SARS病人 30例 ,病程均为 3周以上。统计激素治疗的时间和剂量 ,观察治疗前后CD+ 4 、CD+ 8、CD+ 3 T淋巴细胞计数 ,以及电解质、血象、血清白蛋白变化。结果　激素治疗前 2 7例患者CD+ 4 、CD+ 8、CD+ 3 T淋巴细胞计数分别为 (个 / μl ) 4 0 1± 2 0 3、340± 187、75 6± 383。30例中 2 9例使用甲泼尼龙治疗 ,2 4例剂量为 80～ 16 0mg/d ,最大剂量为 10 0 0mg/d(入我院前 )。应用激素后血白细胞升高 (P <0 .0 1) ;血K+ 、Na+ 、Cl-无明显变化 (P >0 .0 5 ) ;血糖升高 (P =0 .0 1) ;血清白蛋白明显下降 (P <0 .0 1) ;较大剂量的激素可明显抑制CD+ 4 、CD+ 8、CD+ 3 T淋巴细胞的水平 ;3例重症病例在大剂量激素应用下出现二重感染。结论　SARS病人在病程早期免疫功能已受到抑制 ,大剂量应用糖皮质激素可明显加重这一抑制 ,并使机体处于高代谢状态 (血糖升高、血清白蛋白下降 ) ,进一步导致病情加重 ,病人在后期易出现严重继发感染 ,因此应严格掌握激素适应证 ,不宜大剂量使用。     

不同阶段慢性乙型肝炎患者外周血单个核细胞中NF-κB/iNOS的表达及免疫状态

目的研究核因子-κB(NF-κB)/诱导型一氧化氮合成酶(iNOS)在不同阶段慢性乙型肝炎患者外周血单个核细胞(PBMC)中的表达,比较各阶段自然杀伤细胞及T、B淋巴细胞的变化情况。方法纳入福建医科大学附属南平第一医院2017年10月-2019年1月慢性乙型肝炎相关疾病患者,按照疾病不同阶段分4组:肝炎组、肝衰竭组、肝硬化组、肝癌组,每组各20例;另选取10例健康志愿者作为对照组。采用流式细胞仪检测5组外周血总淋巴细胞计数和淋巴细胞亚群计数;采用Western Blot检测PBMC中NF-κB、iNOS蛋白的表达水平;硝酸还原酶法和ELISA法检测血清中NO、IL-6水平。多组间比较采用单因素方差分析,进一步两两比较采用LSD-t检验。结果与对照组比较,肝炎组、肝衰竭组、肝癌组、肝硬化组总淋巴细胞计数水平均明显下降(P值均<0.05);与肝炎组比较,肝衰竭组、肝癌组、肝硬化组总淋巴细胞计数水平均明显下降(P值均<0.05)。肝衰竭组、肝癌组、肝硬化组CD3+明显下降,分别与对照组、肝炎组比较差异均有统计学意义(P值均<0.05);肝衰竭组、肝癌组、肝硬化组与肝炎组CD4+比较明显下降(P<0.05);肝衰竭组与肝癌组、肝硬化组、对照组CD8+比较明显升高(P值均<0.05);肝衰竭组较对照组、肝炎组、肝硬化组、肝癌组CD4+/CD8+明显降低(P值均<0.05);肝衰竭组、肝硬化组CD3-CD19+明显升高,分别与肝炎组、对照组比较差异均有统计学意义(P值均<0.05);肝衰竭组、肝癌组CD16+CD56+明显下降,分别与肝炎组、对照组比较差异均有统计学意义(P值均<0.05)。肝硬化组、肝衰竭组、肝癌组NF-κB、iNOS蛋白表达水平均明显增高,分别与肝炎组、对照组比较差异均有统计学意义(P值均<0.05)。与对照组比较,肝衰竭组、肝癌组、肝硬化组和肝炎组的NO和IL-6水平均明显升高(P值均<0.05)。结论不同阶段HBV感染者免疫状态存在一定差异性,NF-κB-iNOS-NO可能参与HBV相关疾病的免疫反应。     

93例传染性非典型肺炎患者外周血T淋巴细胞亚群变化及临床意义

目的　了解传染性非典型肺炎 (世界卫生组织又称严重急性呼吸综合征 ,SARS)患者外周血T淋巴细胞亚群的变化。方法　采用流式细胞仪对 93例临床确诊的SARS患者、5 0例获得性免疫缺陷综合征 (AIDS)患者及 6 4例健康体检者外周血T淋巴细胞亚群进行检测。 93例患者中 ,男4 0例、女 5 3例 ;年龄 17～ 88岁 ,平均 4 4岁 ;重型 35例、普通型 5 8例。结果　健康体检者外周血CD+ 3 、CD+ 4 、CD+ 8分别为 (15 2 7± 4 70 )、(787± 2 5 7)、(6 33± 2 80 )个 / μl;93例急性期SARS患者分别为(72 2± 5 33)、(438± 35 3)、(30 7± 2 17)个 / μl,均有不同程度的下降 (P值均 <0 .0 1) ,重症病例下降尤其明显 ,5例死亡患者外周血CD+ 4 均低于 2 0 0个 / μl;SARS患者恢复期CD+ 3 、CD+ 4 、CD+ 8多数恢复正常。而AIDS患者以CD+ 4 降低为主 ,为 (2 96± 2 98)个 / μl;且CD+ 8升高 ,为 (818± 5 6 6 )个 / μl。 结论SARS患者有明显的细胞免疫损伤。     

慢性乙型肝炎急性肝衰竭患者外周血免疫活性细胞特点及其与预后的关系

目的慢性乙型肝炎(乙肝)急性肝衰竭(慢加急性肝衰竭,ACLF)的发病机制尚不清楚,本文主要研究ACLF患者的免疫特点及其与预后的关系。方法选取ACLF患者75例,慢性乙型肝炎(CHB)患者31例,乙型肝炎肝硬化(LC)患者36例,健康志愿者30例,采用流式细胞仪检测外周血CD3 、CD4 、CD8 T细胞、NK细胞、NKT细胞等细胞亚群计数,用SPSS10.0软件对其进行统计学分析。结果ACLF组外周血淋巴细胞总数、CD4 、CD8 T细胞、NKT细胞与健康对照组及慢性乙肝组相比,均具有显著性差异(P<0.001或P<0.01或P<0.05)。ACLF组外周血NK细胞与健康对照组相比,具有显著性差异(P<0.01)。ACLF患者死亡组中淋巴细胞总数、CD4 、CD8 T细胞、NK细胞计数均低于存活组各细胞计数,二者具有显著性差异(P<0.05)。结论ACLF患者外周血免疫活性细胞的减少可能是ACLF病情急剧进展的驱动因素。     

慢性丙型肝炎患者淋巴细胞亚群及其凋亡研究

目的 探讨ＨＣＶ感染诱导自身免疫反应的机理。方法 应用ＥＬＩＳＡ和流式细胞术检测了１８例慢性丙型肝炎患者及１６例正常人血清丙型肝炎病毒感染相关自身抗体（抗ＧＯＲ）及抗核抗体（ＡＮＡ）、外周血淋巴细胞（ＰＢＭＣ）亚群及其凋亡百分率。结果 慢性丙型肝炎患者血清抗ＧＯＲ抗体及ＡＮＡ阳性率分别为６６．７％和４４．４％,与正常对照组比较差异均有显著意义（Ｘ＾２＝２６．８６、Ｘ＾２＝９．３０,Ｐ〈０．００５）     

Epidemiological survey of Blastocystis hominis in Huainan City,Anhui Province,China

AIM：To provide scientific evidence for prevention and controlling of blastocystosis,the infection of Blastocystis homon is and to study its dinical significance in Huainan City,Anhui Province,China.METHODS:Blastocystis homonis in fresh stools taken from 100infants,100pupils,100middle school students and 403patie nts with diarrhea was smeared and detected with method of iodine staining and hematoxylin staining,After preliminary direct micosopy,the shape and size of Blastocystis homonis were observed with high power lens.The cellular immune function of the patients with blastocystosis was detected with biotin-streptavidin(BSA).RESULTS:The positive rates of Blastocystis homonis in fresh stools taken from the infants,pupils,middle school students and the patients with diarrhea,were1.0%(1/100),1.0%(1/100),0%(0/100)and5.96%(24/403)respectively,Furthermore,the positive rates of blastocystis homonis in the stool samples taken from the patients with mild diarrhea,intermediate diarrhea,severe diarrhea and obstinate diarhea were6.03%(14/232).2.25%(2/89),0%(0/17)and12.31%(8/65)respectively.The positive rates of Blastocystis homonis in fresh stools of male and female patients with diarrhea were 7.52%(17/226)and3.95%(7/177)respectively,and those of patients in urban and rural areas were4.56%(11/241)and8.02%(13/162)respectively,Theere was no significant difference between them(P&gt;0.05).The positive rates of CD3^+,CD4^+,CD8^+in serum of Blastocystis homonis-positive and-negative individuals were0.64&#177;0.06,0.44&#177;0.06,0.28&#177;0.04and0.60&#177;0.05,0.40&#177;0.05and0.30&#177;0.05respectively,and the ratio ofCD4^+/CD8^+of the two groups were1.53&#177;0.34and1.27&#177;0.22,There was significant difference between the two groups(P&lt;0.05,P&lt;0.01).CONCLUSION:The prevalence of Blastocystis homins as an enteric pathogen in human seems not to be associated with gender and living environment,and that blastocystis hominis is more common in stool samples of the patients with diarrhea ,especially with chronic diarrhea or obstinate diarrhea.When patients with diarrhea infected by Blastocystis hominis,their cellular immune function decreases,which make it more difficult to be cured.     

乙型肝炎病毒特异性细胞毒性T淋巴细胞应答与不同临床感染状态的关系

目的 分析人类白细胞抗原(HLA)-A0201限制性的特异性CTL,研究急性肝炎急性期和慢性乙型肝炎活动期患者T淋巴细胞对特异性抗原表位免疫应答的差异.方法 收集HLA-A0201阳性的5例急性肝炎急性期和6例慢性乙型肝炎活动期患者的外周血单个核细胞(PBMC),酶联免疫斑点技术(ELISPOT)测定针对HBV聚合酶区(Pol575-583)、包膜区(Env348-357)和核心区(Core18-27)3个CD8+T淋巴细胞表位肽特异性CTL的数量和功能.数据采用t检验.结果 经Pol575-583、Env348-357和Core18-27三条抗原肽刺激,急性乙型肝炎急性期患者组斑点形成细胞数(SFC)分别为110±13、165±17和185±20;慢性乙型肝炎活动期患者组SFC分别为22±4、23±5和30±5,两组差异有统计学意义(t值分别为10.9、15.2和8.0,均P<0.05).急性乙型肝炎急性期患者各抗原肽特异性CTL的应答能力Pol575-5830.05).非特异性HLA-2402限制性Core117-125刺激也出现SFC增加,但与阴性对照组比较,差异无统计学意义(P>0.05).结论 急性感染者HBV特异性CTL应答水平显著高于慢性HBV感染者,慢性乙型肝炎患者体内的多克隆CTL数量和功能低下.     

慢性乙型肝炎患者外周血NK细胞和T淋巴细胞计数变化及其临床意义

目的观察慢性乙型肝炎患者外周血NK细胞和T淋巴细胞数量的变化。方法在56例乙型肝炎肝衰竭、49例HBeAg阳性慢性乙型肝炎和41例乙型肝炎病毒携带者使用流式细胞仪检测外周血CD3+T细胞、CD3+CD4+T细胞、CD3+CD8+T细胞和NK(CD3-CD16+CD56+)细胞占淋巴细胞的比率(%)。结果肝衰竭患者CD3+T细胞和CD3-CD16+CD56+NK细胞计数比慢性乙型肝炎患者和乙型肝炎病毒携带者显著性降低(P0.05);慢性乙型肝炎患者CD3-CD16+CD56+NK细胞计数比乙型肝炎病毒携带者显著性升高(P0.05)。结论乙型肝炎肝衰竭患者外周血T细胞和NK细胞数量减少,而HBeAg阳性慢性乙型肝炎患者外周血T细胞数量增多。     

芪黄冲剂对慢性乙型肝炎患者免疫功能的影响

目的：观察芪黄冲剂对慢性乙型病毒性肝炎免疫功能的影响。方法：治疗组以芪黄冲剂治疗,对照组以乙肝清热解毒冲剂合乙肝养阴活血冲剂治疗。两组患者采用间接免疫荧光法检测,治疗前后免疫球蛋白ＩｇＧ、ＩｇＭ、ＩｇＡ、Ｔ淋巴细胞亚群ＣＤ３＾＋、ＣＤ４＾＋、ＣＤ８＾＋、ＣＤ４＾＋／ＣＤ８＾＋、ＩＬ－２、ＩＬ－６、ＴＮＦ、ＮＫ。结果：芪黄冲剂具有益气活血,滋养肝肾兼以清热解毒作用,能升高ＣＤ４＾＋、ＮＫ细胞,提高ＣＤ４＾＋／ＣＤ８＾＋比值及ＩＬ－２水平,降低ＣＥ８＾＋,尤其对ＣＤ４＾＋、ＣＤ４＾＋／ＣＤ８＾＋、ＮＫ细胞以及ＩＬ０２的调整作用优于对照组（Ｐ〈０．０５￣０．０１）,能显著降低ＩＬ－６及ＴＮＦ水平（Ｐ〈０．０５￣０．０１）。同时还能降低ＩｇＧ、ＩｇＭ、ＩｇＳ,其中对ＩｇＡ的降低作用显著优于对照组。结论：芪黄冲剂不仅具有     

外周血DNT细胞和T细胞亚群检测在乙型肝炎病毒感染者诊断中的意义

目的：探讨乙型肝炎病毒感染者外周血CD3＋CD4-CD8-T细胞（DNT）和T细胞亚群的变化及意义。方法使用流式细胞仪检测136例乙型肝炎病毒感染者,包括33例无症状携带者、28例急性乙型肝炎患者、28例轻度慢性乙型肝炎患者、25例中度慢性乙型肝炎患者、22例重度慢性乙型肝炎患者和39例健康人外周血DNT细胞及T细胞亚群。结果健康人群和急性乙型肝炎患者外周血DNT细胞比例分别为（4.82±3.43）%和（4.75±2.71）%,显著低于无症状携带者[（5.43±3.31）%,P〈0.05]和慢性乙型肝炎患者（P〈0.05）;轻度慢性乙型肝炎患者DNT细胞比例为（7.97±4.12）%,显著低于重度慢性乙型肝炎患者[（11.36±5.01）%,P〈0.05];中度慢性乙型肝炎患者DNT细胞比例为（8.41±4.93）%,也显著低于重度慢性乙型肝炎患者（P〈0.05）;健康人、急性乙型肝炎患者和无症状携带者之间 T 淋巴细胞亚群分布无明显差异,但随着慢性乙型肝炎患者病情加重,外周血 CD3＋、CD3＋CD4＋CD8-细胞比例降低（P〈0.05）,CD3＋CD4-CD8＋细胞比例升高（P〈0.05）。结论外周血DNT细胞比例的升高与乙型肝炎病毒感染者慢性化及慢性乙型肝炎患者的疾病进程有关。     

Surface expression and cytolytic function of natural killer cell receptors is altered in chronic hepatitis C

INTRODUCTION: Impaired activity of natural killer (NK) cells has been proposed as a mechanism contributing to viral persistence in hepatitis C virus (HCV) infection. As the function of NK cells is primarily regulated by NK cell receptors (NKR), we analysed whether decreased NK cell function in hepatitis C may be related to dysregulated NKR expression. PATIENTS AND METHODS: Expression of NK cell was analysed by flow cytometry on lymphocytes from HCV(+) subjects (n = 30), patients who became HCV(-) after antiviral therapy (n = 10), healthy individuals (n = 10), and hepatitis B virus (HBV) infected patients (n = 9). Cytolytic function of lymphocytes was studied in a redirected lysis assay and in a standard 51chromium release cytotoxicity assay, respectively. RESULTS: In patients with chronic hepatitis C, we found a significantly reduced proportion of NKp46 and NKp30 expressing NK cells compared with healthy and HBV infected subjects. Low expression of natural cytotoxicity receptor (NCR) was also confirmed in in vitro activated NK cell populations derived from HCV patients compared with uninfected donors. In contrast, patients who cleared HCV under antiviral therapy showed normal expression of NKp44, NKp30, and NKp46. Reduced NCR expression in chronic hepatitis C was associated with a parallel decrease in NCR mediated target cell killing. Furthermore, we found a significantly increased proportion of NKG2A expressing NK cells and CD8+ T cells in HCV positive patients, resulting in a reduced cytolytic activity against cells incubated with the HLA-E stabilising peptide HCV core35-44. CONCLUSION: The present study indicates that defective expression of NKR represents a novel mechanism contributing to impaired function of NK cells and CD8+ T cells in chronic hepatitis C.     

Relationship between serum cytokine levels and histopathological changes of liver in patients with hepatitis B

AIM: To investigate whether there was a relationship between the liver functions and fibrosis scores of hepatitis B patients and their TNF-α, IFN-γ,IL-4, and TGF-β1 serum levels based on the studies of liver biopsies. METHODS: Thirty patients with chronic hepatitis B (CHB) receiving no treatment and 30 healthy individuals with negative hepatitis serology and normal values of liver biochemistry were studied. After serum samples of the patients were collected, liver needle biopsy was performed on each patient. Cytokine levels were studied by ELISA. The biopsy materials were scored based on Knodell's histological activity index. RESULTS: In comparison of cytokine levels between CHB patients and control group, TNF-α,IL-4, and TGPβ1 levels of the patients were higher in CHB patients than in the controls, while IFN-γ level was lower in the patients than in the controls. There were significant differences between the groups in TNF-α, IL-4, TGF-β1, and IFN-γ(P<0.005, 0.03, 0.002, 0.0001,respectively).There was a negative correlation between TGF-β1 and IL-4 and IFN-γ(P<0.05), TNF-α and the other cytokines and IFN-γ and IL-4 were not correlated (P>0.05). TGF-β1 was correlated with fibrosis (P<0.05).Liver necroinflammatory activity and fibrosis and TNF-α, IL-4, and IFN-γ were not correlated (P>0.05). CONCLUSION: In the course of HBV infection and its chronic progress, cytokines play an important role. IL-4 and IFN-γ are effective in the chronic progression, while TGF-β1 is effective in the development of fibrosis. Serum cytokine levels may be effective tools in the estimation of chronic progression and fibrosis development.