慢性乙型肝炎患者抗病毒治疗过程中程序性死亡分子1及其配体表达的变化

目的 探讨慢性乙型肝炎患者在抗病毒治疗过程中程序性死亡分子1(PD-1)及其主要配体PD-L1表达的变化情况及其与HBeAg/抗-Hbe血清学转换的关系.方法 对10例人类白细胞抗原(HLA)-A2阳性的HBeAg阳性慢性乙型肝炎患者予以替比夫定抗病毒治疗24 周,分别于治疗的0、12周和24周随访,检测HBV DNA水平、外周血单个核细胞(PBMC)表面PD-1和PD-L1表达水平、HBV特异性T淋巴细胞数量与其表达PD 1水平,及PBMC体外培养上清液中干扰素(IFN)γ水平.其中HBV DNA定量采用荧光定量PCR法检测;PBMC自新鲜血分离,部分PBMC加入重组HBcAg体外培养7d,加入HBV抗原表位肽五聚体复合体;PD-1和PD-L1阳性细胞、CD8'T淋巴细胞以及CD8和PD-1双阳性细胞用流式细胞仪检测;IFN γ水平用酶联免疫吸附试验检测.比较不同时间点PBMC表面PD-1和PD L1表达水平、HBV特异性CD8'T淋巴细胞数量及其PD-1表达水平、PBMC培养上清液中IFN γ水平.对抗病毒治疗前后对应指标数值的变化采用配对t检验分析.结果 治疗前HBV DNA水平为5.16～8.77 log10拷贝/ml,治疗24周时,7例HBV DNA水平低于检测下限,3例仍可检测到,但明显低于基线水平.2例HBeAg/抗-Hbe血清学转换,2例HBeAg阴转,6例仍维持HBeAg阳性.0、12周和24周PBMC表面PD 1表达水平分别为52.1%±17.0%、39.1%±18.2%和23.4%±16.3%(24周和0周比较,P＜0.01);PD-L1分别为45.6%±15.4%、34.6%±16.2%和20.9%±9.5%(24周和0周,P＜0.01;24周和12周比较P＜0.05);HBV特异性T淋巴细胞上PD-1表达水平分别为76.2%±10.4%、66.5%±15.4%和49.5%±25.3%(24周和0周比较,P＜0.01;12周和0周比较,P＜0.05;24周和12周比较,P＜0.05);HBV特异性T淋巴细胞分别为1.3%±0.5%、1.5%±1.0%和2.2%±1.5%; IFN γ水平(pg/ml)分别为91.7±82.1、99.4+93.5和109.0+86.6.24周HBeAg/抗-Hbe血清学转换者上述指标变化明显大于无HBeAg/抗-Hbe血清学转换者.结论 直接抑制HBV复制能降低PD-1、PD-L1表达水平,并增加HBV特异性CD8'T淋巴细胞的数量和功能.早期PD-1快速下降和HBV特异性T淋巴细胞数量及功能的恢复与早期HBeAg/抗-Hbe血清学转换的关系有待于进一步研究.     

慢性乙型肝炎病毒感染者肝组织中程序性死亡分子-1及其配体的表达

目的 通过比较慢性HBV感染免疫耐受期和免疫清除期的患者肝组织中程序性死亡分子-1及其配体的表达情况,探讨其与机体免疫功能状态的关系.方法 收集肝组织活体检查标本并分为免疫清除期组25例、免疫耐受期组19例,用免疫组织化学方法检测标本汇管区中T淋巴细胞程序性死亡分子-1及其配体的表达情况,通过半定量评分系统计算其占CD3阳性细胞的百分数,用t检验比较两组病例间程序性死亡分子-1及其配体表达的差异.结果 免疫耐受期组肝组织汇管区T淋巴细胞中程序性死亡分子-1所占CD3阳性细胞比率为63.79%±6.94%,高于免疫清除期的54.36%±10.08%,两组比较,t=3.492,P<0.01,差异有统计学意义;程序性死亡分子配体-1于T淋巴细胞中的表达在免疫耐受期组(66.47%±8.40%)中高于免疫清除期组(52.64%±6.20%),两组比较,t=6.288,P<0.01,差异有统计学意义.程序性死亡分子配体-1在枯否细胞中的表达强度及范围在两组间差异无统计学意义(P>0.05).结论 慢性HBV感染者肝组织中的程序性死亡分子-1及其配体表达水平的差异反映了免疫耐受期和免疫清除期的不同免疫功能状态.

Abstract：

Objective To detect and compare the PD- 1/PD-L1 (programmed death 1/programmed death 1 ligand) expressions in the liver tissues of chronic HBV infection patients in immune tolerant phase and those in immune clearance phase. Methods Liver biopsy samples were divided into two groups: 25 samples from patients in immune clearance phase and 19 samples from patients in immune tolerant phase.PD-1/PD-L1 expressions on T lymphocytes in these liver biopsy specimens were detected by immunobis tochemistry method. Percentage of PD-1/PD-L1 positive cells among CD3 positive cells was calculated by semi-quantitative evaluation. Differences between the two groups were statistically analyzed. Results PD1/PD-L1 expressions were significantly higher in the patients in immune tolerant phase as compared to that in immune active phase (P < 0.05). No statistical difference found between the two groups for PD-L1 expression in Kupffer cells (P > 0.05). Conclusion PD-1/PD-L1 expression level can reflect the immune functions of chronic hepatitis B patients.     

慢性乙型肝炎病毒感染者肝组织中程序性死亡分子-1及其配体的表达

目的 通过比较慢性HBV感染免疫耐受期和免疫清除期的患者肝组织中程序性死亡分子-1及其配体的表达情况,探讨其与机体免疫功能状态的关系.方法 收集肝组织活体检查标本并分为免疫清除期组25例、免疫耐受期组19例,用免疫组织化学方法检测标本汇管区中T淋巴细胞程序性死亡分子-1及其配体的表达情况,通过半定量评分系统计算其占CD3阳性细胞的百分数,用t检验比较两组病例间程序性死亡分子-1及其配体表达的差异.结果 免疫耐受期组肝组织汇管区T淋巴细胞中程序性死亡分子-1所占CD3阳性细胞比率为63.79%±6.94%,高于免疫清除期的54.36%±10.08%,两组比较,t=3.492,P<0.01,差异有统计学意义;程序性死亡分子配体-1于T淋巴细胞中的表达在免疫耐受期组(66.47%±8.40%)中高于免疫清除期组(52.64%±6.20%),两组比较,t=6.288,P<0.01,差异有统计学意义.程序性死亡分子配体-1在枯否细胞中的表达强度及范围在两组间差异无统计学意义(P>0.05).结论 慢性HBV感染者肝组织中的程序性死亡分子-1及其配体表达水平的差异反映了免疫耐受期和免疫清除期的不同免疫功能状态.     

芪灵合剂对慢性乙型肝炎患者T细胞表面程序性死亡1和程序性死亡配体1表达的影响

目的：观察中药芪灵合剂对慢性乙型肝炎（CHB）患者外周血CD4＋T淋巴细胞表面程序性死亡1（Programmed death-1,PD-1）及程序性死亡配体1（Programmed death-1 ligand1,PD-L1）表达水平的影响。方法：收集56例CHB患者随机分为芪灵合剂联合拉米夫定片（LAM）治疗组29例和单用LAM对照组27例,于抗病毒治疗的第0、24、48周用流式细胞术检测外周血CD4＋T淋巴细胞及其表面的PD-1/PD-L1的表达情况。结果：治疗48周后,治疗组患者HBV DNA转阴率、ALT复常率均高于对照组,与对照组比较,HBV DNA转阴率具有统计学意义（P〈0.05）。治疗组患者外周血CD4＋T细胞表面PD-1 24周、48周表达水平与治疗前比较逐渐下降;48周时与本组治疗前比较差异有统计学意义（P〈0.01）,与对照组比较差异有统计学意义（P〈0.05）。治疗组患者CD4＋T细胞PD-L1 48周后表达水平与治疗前比较差异有统计学意义（P〈0.01）,与对照组比较差异有统计学意义（P〈0.05）。结论：中药芪灵合剂联合LAM能够提高CHB患者HBV DNA转阴率,ALT复常率,其作用机制可能与抑制CD4＋T淋巴细胞表面PD-1/PD-L1的表达有关。     

慢性乙型肝炎患者外周血单核细胞亚群表面程序性死亡配体1表达

目的 探讨程序性死亡配体1(PD-L1)在慢性乙型肝炎患者外周血单核细胞亚群表面的表达情况.方法 利用荧光抗体标记结合多色流式技术,检测慢性乙型肝炎患者外周血单核细胞各亚群表面PD-L1分子的表达.结果 慢性乙型肝炎患者外周血单核细胞PD-L1的表达率与血清AST水平呈正相关(r=0.358,P=0.035),且免疫活...     

抗病毒治疗慢性丙型肝炎患者T细胞表面程序性死亡1和程序性死亡配体1的表达

目的 观察慢性丙型肝炎(CHC)患者抗病毒治疗24周时外周血CD4+和CD8+T淋巴细胞(T细胞)表面表面程序性死亡1 (PD-1)和程序性死亡配体1(PD-L1)表达水平,分析其与抗病毒治疗临床转归的关系.方法 24例CHC患者,均采用聚乙二醇干扰素α-2a (Peg-IFN α-2a)每周皮下注射一次,联合利巴韦林800 ～ 1200 mg/d,治疗24 ～ 48周.采用流式细胞术和实时荧光定量检测患者治疗前、治疗4、12、24周外周血CD4+和CD8+T细胞表面PD-1、PD-L1表达水平和外周血HCV RNA,全自动生化分析仪检测ALT.采用SPSS16.0软件.两样本计量结果分析采用t检验,治疗前后的计量结果采用重复测量的单因素或两因素方差分析,所有检验为双侧检验. 结果 CHC患者治疗后4周HCV RNA阴性者19例,CD4+和CD8+T细胞表面PD-1的表达率在治疗前分别为18.6％±6.1％和16.6％±13.8％,治疗24周时分别为10.3％±7.7％和9.4％±4.6％,治疗前后比较,PD-1的表达明显下降,F值为12.406和4.955,P值为0.002和0.039,差异有统计学意义.CD8+T细胞表面PD-L1的表达率在治疗前为17.5％±13.7％,治疗4、12、24周时分别为25.9％±11.1％、29.6％±15.1％、32.0％±15.7％,治疗后明显升高,F值分别为9.063、8.365、9.736,P值均＜0.01.治疗4周时,HCV RNA阳性者5例,仅发现CD8+T细胞表面PD-L1的表达治疗24周(39.2％±15.6％)与治疗前(17.4％±16.7％)比较明显升高,F=10.292,P=0.033.持续病毒学应答者20例:CD4+T细胞表面PD-1的表达在治疗4、12、24周分别为14.4％±7.5％、14.0％±6.9％、10.7％±7.6％,治疗前为20.2％±7.5％,与治疗前比较明显下降,F值分别为6.133、5.541、14.780,P＜0.05或P＜0.01.CD8+T细胞表面PD-1的表达在治疗12、24周分别为10.2％±4.6％和10.1％±4.9％,治疗前为16.8％±13.4％,治疗前后比较,PD-1的表达在治疗后明显下降,F值为4.964和4.613,P值均＜0.05.CD8+T细胞表面PD-L1的表达在治疗12、24周分别为30.8％±16.6％和35.2％±16.5％,治疗前为19.0％±14.5％,治疗后明显升高,F=6.442,P=0.020和F=12.349,P=0.002.复发组4例,各治疗时间点PD-1和PD-L1与治疗前比较,差异无统计学意义.结论 快速有效的抗病毒治疗可以下调CHC患者外周血CD4+和CD8+T细胞表面PD-1的表达,上调CD8+T细胞表面PD-L1的表达.CHC患者外周血CD4+和CD8+T细胞表面PD-1和PD-L1表达水平的变化可能与患者抗病毒治疗临床转归存在关系.     

程序性死亡因子配体1在肝细胞癌中的表达及意义

近年来以阻断PD-1/PD-L1通路为基础的免疫治疗在黑色素瘤、肺癌等恶性肿瘤中取得令人鼓舞的进展,其在肝细胞癌中的研究也在逐渐展开。介绍了PD-1/PD-L1作用机制、肝细胞癌组织中PD-L1的表达情况以及其在肝细胞癌治疗领域的基础及临床研究。认为PD-L1在肿瘤免疫逃逸中发挥重要作用,有望成为判断肝细胞癌预后的独立指标,PD-1/PD-L1通路的发现为肝细胞癌的免疫治疗提供了新的靶点。     

慢性乙型肝炎患者外周血CD8+T淋巴细胞表面程序性死亡受体-1表达上调的意义

程序性死亡受体-1(PD-1)主要表达于活化的淋巴细胞和单核细胞,尤其是体内活化的T淋巴细胞表面[1],负性调节其活化、增殖和细胞因子的产生[2-3],使人类免疫缺陷病毒(HIV)[4]、HCC[5]、HBV[6-7]等慢性感染过程中患者的病毒特异性CD8+细胞毒性T淋巴细胞(CTL)功能受到抑制,从而造成持续性感染状态.     

免疫清除期慢性乙型肝炎患者外周血T细胞程序性坏死因子-1表达及其意义

目的 明确程度性坏死因子（PD-1）在免疫清除期慢性乙型肝炎患者外周血T细胞表达状态及其对患者病毒载量水平和生化指标的影响.方法 45例ALT升高的慢性乙型肝炎患者被纳入本研究.应用流式细胞术对所有患者的外周血总CD8+T细胞和CD4+T细胞PD-1表达百分比和表达强度进行检测,其中18例患者接受肝组织活检,并应用免疫...     

恩替卡韦治疗后慢性乙型肝炎患者外周血T淋巴细胞表面程序性死亡受体1表达与HBeAg血清学转换的关系

目的 动态观察慢性乙型肝炎患者恩替卡韦抗病毒治疗后不同时期外周血T淋巴细胞(简称T细胞)表面程序性死亡受体1(PD-1)表达的变化,并探讨其与HBeAg血清学转换间的关系.方法 对20例HBeAg阳性慢性乙型肝炎患者予以恩替卡韦抗病毒治疗并随访51周,根据HBeAg是否发生血清学转换分为:HBeAg未转换组(14例),HBeAg转换组(6例).分别于治疗前(基线,T0)、治疗2～4周(T1)、治疗5～10周(T2)、治疗11～20周(T3)、治疗21～30周(T4)、治疗31～51周(T5)收集外周血,流式细胞术检测CD4+、CD8+T细胞表面PD-1的表达水平,实时荧光定量PCR检测血清HBV DNA载量,同时检测血清ALT水平.正态分布资料采用独立样本t检验,非正态分布者采用Mann-Whitney U检验比较组间差异,相关性分析采用Pearson相关分析.结果 治疗前两组患者血清HBV DNA载量分别为(7.54±0.67)log10拷贝/ml、(7.30±0.79)log10拷贝/ml(P＞0.05),ALT水平为(187.26±184.15)U/L、(272.17±215.07)U/L(P＞0.05),外周血CD4+T细胞表面PD-1表达水平为6.04%±3.71%6.77%±2.88%(P＞0.05),CD8+T细胞表面PD-1表达水平为6.39%±3.33%、8.88%±2.84%(P＞0.05).恩替卡韦抗病毒治疗后两组患者血清HBV DNA载量、ALT水平的下降与CD4+、CD8+T细胞表面PD-1表达的下调呈显著正相关(r=0.212,P=0.05;r=0.377,P＜0.01;r=0.279,P＜0.05;r=0.347,P＜0.01).在相同的随访时间段内,HBeAg转换组血清HBV DNA载量、ALT水平及外周血CD4+、CD8+T细胞表面PD-1表达的下降率均高于HBeAg未转换组,且两组间△ T0～T1、△T0～T2期HBV DNA的下降率及△T0～T2、△T0～T3期CD8+T细胞表面PD-1表达的下降率差异有统计学意义(分别为49.9%对比37.3%,56.7%对比47.4%,70.1%对比-4.2%,66.9%对比24.5%,P值均＜0.05).结论 HBeAg阳性慢性乙型肝炎患者经恩替卡韦抗病毒治疗后,外周血CD8+T细胞表面PD-1表达的快速下调与血清HBV DNA相似,可作为预测后期HBeAg血清学转换的指标之一.

Abstract：

Objective To observe longitudinally the expression of Programmed death 1 (PD-1) on peripheral blood T cells in chronic hepatitis B patients underwent antiviral treatment with entecavir (ETV)and to explore the relationship between PD-1 expression and HBeAg seroconversion.Methods Twenty HBeAg positive patients underwent antiviral treatment with ETV were followed up for 51 weels.14 patients remained HBeAg positive and 6 patients achieved HBeAg seroconversion.Peripheral blood was collected at six time points:T0:baseline,T1:2-4week;T2:5-10week;T3:11-20week;T4:21-30week:T5:31-51week.PD-1 expressions on T cells were assessed by flow cytometry.Serum HBV DNA loads were determined by real-time fluorescent quanttative polymerase chain reaction (PCR) and serum ALT levels were examined at the same time.Results At baseline,serum HBV DNA load of patients without HBeAg seroconversion and with HBeAg seroconversion were (7.54 ± 0.67) log10 copies/ml and (7.30 ± 0.79) log10 copies/ml(P ＞ 0.05),the ALT levels were (187.26 ± 184.15) U/L and (272.17 ± 215.07) U/L (P ＞ 0.05),PD-1 exprissions on CD4+ T cells were 6.04% ± 3.71% and 6.77% ± 2.88% (P ＞ 0.05),PD-1 exprissions on CD8+ T cells were 6.39% ± 3.33% and 8.88% ± 2.84% (P ＞ 0.05).After ETV treatment,serum HBV DNA loads and ALT levels both decreased gradually,which was positively correlated with PD-1 expressions on CD4+ and CD8+ T cells (r = 0.212,P = 0.05;r = 0.377,P ＜ 0.01;r = 0.279,P ＜ 0.05;r = 0.347,P ＜ 0.01 ).During the same monitoring period,the HBV DNA loads,ALT levels and PD-1 expressions on T cells of the patients with HBeAg seroconversion decreased significantly as compared with the patients without HBeAg seroconversion.Besides,the decrease of HBV DNA loads during period △ T0-T1 and △ T0-T2 and PD-1 expressions on CD8+ T cells during period △ T0-T2 and △ T0-T3 were significantly different between these two kinds of patients (49.9% vs 37.3%,P ＜ 0.05;56.7% vs 47.4%,P ＜ 0.05;70.1% vs -4.2%,P ＜ 0.05;66.9% vs 24.5%,P ＜ 0.05).Conclusion The rapid decrease of PD-1 expression on peripheral CD8+ T cells after antiviral treatment with ETV is positvely correlated with the decrease of serum HBV DNA loads and may be used as a predictive index for HBeAg seroconversion in HBeAg positive patients.     

慢性乙型肝炎病毒感染者外周血单个核细胞表达程序性死亡分子-1及其配体与血清乙型肝炎病毒DNA水平的相关性

目的 研究程序性死亡分子-1(PD-1)及其配体(PD-L1)表达水平与慢性HBV感染者HBV DNA水平的相关性及抗病毒治疗对其表达的影响.方法 检测137例慢性HBV感染者的外周血单个核细胞(PBMC)表面PD-1和PD-L1,并检测其中64例人类白细胞抗原(HLA)-A2阳性者HBV特异性CTL数量.ELlSA法检测PBMC体外培养上清液中IFN-γ浓度.比较10例HBeAg阳性慢性乙型肝炎(CHB)患者予替比夫定抗病毒治疗24周前后上述指标的变化.两组间均数比较采用两独立样本的t检验,多组间的差异采用单因素方差分析,相关分析采用Pearson相关分析.结果 HBV DNA＜3 lg、3～6 lg和＞6 lg拷贝/mL组问PBMC表面PD-1和PD-L1表达均明显高于健康对照组,但差异无统计学意义;3组HBV特异性CTL表面PD-1表达分别为(69.3±11.2)%、(76.5±9.1)%和(78.0±11.7)%,HBV DNA＞6 lg拷贝/mL 组PD-1表达明显高于＜3 lg拷贝/mL组,而HBV特异性CTL数量明显低于＜3 lg拷贝/mL组;3组PBMC体外培养上清液中IFN-γ水平差异无统计学意义.HBeAg阳性组和阴性组间上述指标差异无统计学意义.替比夫定抗病毒治疗12周和24周时,PD-1、PD-L1表达较治疗前明显下降,伴有HBV特异性CTL数量逐渐增加和IFN-γ水平升高.结论 慢性HBV感染者PBMC表面PD-1的表达较健康者明显上调,且HBV特异性CTL表面表达PD-1水平与血清HBV DNA水平相关,但与HBeAg状态无关.抑制HBV复制能降低PD-1、PD-L1表达,并增加HBV特异性CTL的数量和功能.

Abstract：

Objective To study the relationship between programmed death-1 (PD-1)/programmed death-1 ligand (PD-L1) expressions and serum hepatitis B virus (HBV) DNA levels in chronic hepatitis B (CHB) patients. Methods A total of 137 CHB patients and 10 healthy controls were enrolled in the study. The peripheral blood mononuclear cells (PBMCs) were isolated from fresh blood samples. HBV-specific cytotoxic T lymphocyte (CTL) was expanded in vitro in 64 human leucocyte antigen (HLA)-A2 positive patients. Flow cytometry was used to detect HLA-A2 type,expressions of PD-1/PD-L1 on PBMCs and PD-1 on HBV specific CTL. Interferon gamma (IFN-γ)was measured by commercial enzyme-linked immunosorbent assay (ELISA) kits. PD-1/PD-L1expressions on PBMCs, HBV-specific CTL and IFN-γ level in PBMC culture medium were compared among patients with different baseline HBV DNA levels. Ten hepatitis B e antigen (HBeAg) positive patients were treated with telbivudine for 24 weeks. The above mentioned parameters were determined and compared before and after the antiviral treatment. Independent-samples t test were used to compare means between two groups and one-way A NOVA were used to compare means among multigroups. We used the pearson corretation test to assess corretation significance. Results The PD-1 and PD-L1 expressions on PBMCs in patients with baseline HBV DNA＜3 lg copy/mL, 3-6 lg copy/mL and ＞6 lg copy/mL were all significant higher than those in healthy control group, but no statistical differences were found. PD-1 expressions on HBV-specific CTL in the three CHB patient groups were (69.3±11.2)%, (76.5±9. 1)% and (78.0±11.7)%, respectively. However, PD-1 expression on HBV-specific CTL was higher, while the frequency of HBV-specific CTL cells was lower in HBV DNA ＞6 lg copy/mL group compared to HBV DNA＜3 lg copy/mL group. The above parameters, including expressions of PD-1 and PD-L1, the frequency of HBV-specific CTL and its PD-1 expression were not significantly different between HBeAg-positive group and HBeAg-negative group. Compared with baseline, PD-1 and PD-L1 expression decreased obviously accompanying with increase of HBV-specific CTL cells frequency and IFN-γ level after 12 weeks and 24 weeks of telbivudine treatment. Conclusions PD-1 expression on HBV-specific CTL correlates with serum HBV DNA level, but not HBeAg status in CHB patients. Suppression of HBV replication can reduce PD-1/PD-L1 expressions and partially restore HBV specific CTL function.     

Costimulatory molecule programmed death-1 in the cytotoxic response during chronic hepatitis C

Hepatitis C virus (HCV)-specific CD8~+ T cells play an important role in the resolution of HCV infection. Nevertheless, during chronic hepatitis C these cells lack their effector functions and fail to control the virus.HCV has developed several mechanisms to escape immune control. One of these strategies is the upregulation of negative co-stimulatory molecules such us programmed death-1 (PD-1). This molecule is upregulated on intrahepatic and peripheral HCV-specific cytotoxic T cells during acute and chronic phases of the disease, whereas PD-1 expression is low in resolved infection. PD-1 expressing HCV-specific CD8~+ T cells are exhausted with impairment of several effector mechanisms, such as: type-1 cytokine production, expansion ability after antigen encounter and cytotoxic ability. However, PD-1 associated exhaustion can be restored by blocking the interaction between PD-1 and its ligand (PD-L1). After this blockade, HCV-specific CD8~+ T cells reacquire their functionality. Nevertheless,functional restoration depends on PD-1 expression level.High PD-1-expressing intrahepatic HCV-specific CD8~+ T cells do not restore their effector abilities after PD-1/ PD-L1 blockade. The mechanisms by which HCV is able to induce PD-1 up-regulation to escape immune control are unknown. Persistent TCR stimulation by a high level of HCV antigens could favour early PD-1 induction, but the interaction between HCV core protein and gC1q receptor could also participate in this process. The PD-1/PD-L1 pathway modulation could be a therapeutic strategy, in conjunction with the regulation of others co-stimulatory pathways, in order to restore immune response against HCV to succeed in clearing the infection.     

慢性乙型肝炎病毒感染者外周血单个核细胞表达程序性死亡分子-1及其配体与血清乙型肝炎病毒DNA水平的相关性

Objective To study the relationship between programmed death-1 (PD-1)/programmed death-1 ligand (PD-L1) expressions and serum hepatitis B virus (HBV) DNA levels in chronic hepatitis B (CHB) patients. Methods A total of 137 CHB patients and 10 healthy controls were enrolled in the study. The peripheral blood mononuclear cells (PBMCs) were isolated from fresh blood samples. HBV-specific cytotoxic T lymphocyte (CTL) was expanded in vitro in 64 human leucocyte antigen (HLA)-A2 positive patients. Flow cytometry was used to detect HLA-A2 type,expressions of PD-1/PD-L1 on PBMCs and PD-1 on HBV specific CTL. Interferon gamma (IFN-γ)was measured by commercial enzyme-linked immunosorbent assay (ELISA) kits. PD-1/PD-L1expressions on PBMCs, HBV-specific CTL and IFN-γ level in PBMC culture medium were compared among patients with different baseline HBV DNA levels. Ten hepatitis B e antigen (HBeAg) positive patients were treated with telbivudine for 24 weeks. The above mentioned parameters were determined and compared before and after the antiviral treatment. Independent-samples t test were used to compare means between two groups and one-way A NOVA were used to compare means among multigroups. We used the pearson corretation test to assess corretation significance. Results The PD-1 and PD-L1 expressions on PBMCs in patients with baseline HBV DNA＜3 lg copy/mL, 3-6 lg copy/mL and ＞6 lg copy/mL were all significant higher than those in healthy control group, but no statistical differences were found. PD-1 expressions on HBV-specific CTL in the three CHB patient groups were (69.3±11.2)%, (76.5±9. 1)% and (78.0±11.7)%, respectively. However, PD-1 expression on HBV-specific CTL was higher, while the frequency of HBV-specific CTL cells was lower in HBV DNA ＞6 lg copy/mL group compared to HBV DNA＜3 lg copy/mL group. The above parameters, including expressions of PD-1 and PD-L1, the frequency of HBV-specific CTL and its PD-1 expression were not significantly different between HBeAg-positive group and HBeAg-negative group. Compared with baseline, PD-1 and PD-L1 expression decreased obviously accompanying with increase of HBV-specific CTL cells frequency and IFN-γ level after 12 weeks and 24 weeks of telbivudine treatment. Conclusions PD-1 expression on HBV-specific CTL correlates with serum HBV DNA level, but not HBeAg status in CHB patients. Suppression of HBV replication can reduce PD-1/PD-L1 expressions and partially restore HBV specific CTL function.     

慢性乙型肝炎病毒感染者外周血单个核细胞表达程序性死亡分子-1及其配体与血清乙型肝炎病毒DNA水平的相关性

Objective To study the relationship between programmed death-1 (PD-1)/programmed death-1 ligand (PD-L1) expressions and serum hepatitis B virus (HBV) DNA levels in chronic hepatitis B (CHB) patients. Methods A total of 137 CHB patients and 10 healthy controls were enrolled in the study. The peripheral blood mononuclear cells (PBMCs) were isolated from fresh blood samples. HBV-specific cytotoxic T lymphocyte (CTL) was expanded in vitro in 64 human leucocyte antigen (HLA)-A2 positive patients. Flow cytometry was used to detect HLA-A2 type,expressions of PD-1/PD-L1 on PBMCs and PD-1 on HBV specific CTL. Interferon gamma (IFN-γ)was measured by commercial enzyme-linked immunosorbent assay (ELISA) kits. PD-1/PD-L1expressions on PBMCs, HBV-specific CTL and IFN-γ level in PBMC culture medium were compared among patients with different baseline HBV DNA levels. Ten hepatitis B e antigen (HBeAg) positive patients were treated with telbivudine for 24 weeks. The above mentioned parameters were determined and compared before and after the antiviral treatment. Independent-samples t test were used to compare means between two groups and one-way A NOVA were used to compare means among multigroups. We used the pearson corretation test to assess corretation significance. Results The PD-1 and PD-L1 expressions on PBMCs in patients with baseline HBV DNA＜3 lg copy/mL, 3-6 lg copy/mL and ＞6 lg copy/mL were all significant higher than those in healthy control group, but no statistical differences were found. PD-1 expressions on HBV-specific CTL in the three CHB patient groups were (69.3±11.2)%, (76.5±9. 1)% and (78.0±11.7)%, respectively. However, PD-1 expression on HBV-specific CTL was higher, while the frequency of HBV-specific CTL cells was lower in HBV DNA ＞6 lg copy/mL group compared to HBV DNA＜3 lg copy/mL group. The above parameters, including expressions of PD-1 and PD-L1, the frequency of HBV-specific CTL and its PD-1 expression were not significantly different between HBeAg-positive group and HBeAg-negative group. Compared with baseline, PD-1 and PD-L1 expression decreased obviously accompanying with increase of HBV-specific CTL cells frequency and IFN-γ level after 12 weeks and 24 weeks of telbivudine treatment. Conclusions PD-1 expression on HBV-specific CTL correlates with serum HBV DNA level, but not HBeAg status in CHB patients. Suppression of HBV replication can reduce PD-1/PD-L1 expressions and partially restore HBV specific CTL function.     

B7-H1及其受体PD-1在慢性乙型肝炎患者淋巴细胞上的表达及意义

目的研究B7-H1及其受体PD-1在慢性乙型肝炎患者T淋巴细胞及髓样树突细胞（mDCs）上的表达及它们的表达水平与患者疾病状态的关系。方法流式细胞技术检测正常人和慢性乙型肝炎患者CD4^＋、CD8^＋T淋巴细胞及mDCs上B7-H1和PD-1的表达水平。实时定量PCR检测患者的HBV DNA。结果慢性乙型肝炎患者B7-H1及其受体PD-1的表达水平明显升高,健康对照mDCs、CD4^＋及CD8^＋T淋巴细胞B7-H1的阳性表达率分别为0.35%±0.10%、3.63%±0.70%和1.20%±0.19%,慢性乙型肝炎患者分别为7.88%±1.40%、24.28%±2.86%和10.78%±1.62%,慢性乙型肝炎患者B7-H1在mDCs和T淋巴细胞上的表达水平明显高于健康对照（P值均〈0.05）健康对照CD4^＋及CD8^＋T淋巴细胞PD-1的阳性表达率分别为5.92%±1.75%和5.98%±0.88%,慢性乙型肝炎患者分别为17.76%±2.47%和11.92%±2.21%,慢性乙型肝炎患者PD-1在T淋巴细胞上的表达水平也明显高于健康对照（P值均〈0.05）。且它们的表达与患者的ALT水平及HBV DNA载量呈明显的正相关（P值均〈0.05）。结论慢性乙型肝炎患者淋巴细胞上B7-H1和PD-1的表达水平与患者疾病状态密切相关。     

长片段RNA抑制HepG2.2.15细胞中HBV基因的表达和复制

目的 评估长的反义RNA干扰片段在培养细胞株中对HBV复制的抑制效应.方法将HBV基因组S区的全部核苷酸序列插入至pTARGETTM载体中,并将重组载体转染入HepG2.2.15细胞中.用酶联免疫吸附法检测HBsAg与HBeAg水平,用荧光定量PCR法检测HBVDNA水平.对数据采用多个独立样本Kruskal-Wallis检验与两两比较的Mann-Whitney U检验.结果 经过处理后,HepG2.2.15细胞上清液中HBsAg表达量(A值)在HBS2组(携带长片段反义RNA)为0.621±0.027,在HBS4组(携带正义RNA)为3.399±0.018,对照组为2.232±0.187;HBeAg表达量(A值)在HBS2组、HBS4组和对照组分别为0.749±0.019、1.548±0.025和1.570±0.044; HBV DNA水平(×104拷贝/ml)在HBS2组、HBS4组、对照组分别为1.597±0.082、3.381±0.297和3.610±0.063.与对照组相比,HBS2组HBsAg、HBeAg和HBV DNA表达量均降低,统计量Z值均为-2.309,P值均＜0.05; HBS4组HBsAg表达量增高(Z=-2.309,P＜0.05),而HBeAg和HBV DNA表达量无明显差异,统计量Z值分别为-0.866、-1.155,P值均＞0.05.结论 长片段反义RNA能抑制HBV基因的表达和病毒复制.

Abstract：

Objective To evaluate the inhibitory effects of long antisense RNA on HBV replication in HepG2.2.15 cells. Methods The coding region of HBV S gene was cloned into pTARGET vector in sense and antisense orientations and the recombinant plasmids were transfected into HepG2.2.15 cells which were divided into HBS2 (antisense RNA) group, HBS4 (sense RNA) group and control group. HBsAg and HBeAg in the culture supernant were detected by ELISA. The HBV DNA in the supernant was quantified by real-time PCR. Results After treatment, the levels of HBsAg in HepG2.2.15 cell supernatants of three groups were 0.621 ± 0.027, 3.399 ± 0.018 and 2.232 ± 0.187 respectively; the levels of HBeAg were 0.749 ± 0.019,1.548 ± 0.025 and 1.570 ± 0.044 respectively and the levels of HBV DNA were 1.597 ± 0.082, 3.381 ± 0.297 and 3.610 ± 0.063 respectively. The expressions of HBsAg and HBeAg and the HBV DNA level in HBS2 group were remarkably reduced as compared to the control (Z = -2.309, P ＜ 0.05); whereas the sense plasmid transfection (HBS4) did not affect HBeAg (Z= -0.866) and HBV DNA (Z = -1.155) levels in the culture supernant but slightly increased the HBsAg level (Z = -2.309). Conclusion Antisense RNA might be a useful tool to repress HBV replication.     

乙型肝炎病毒总DNA、共价闭合环状DNA和HBsAg在各种慢性乙型肝炎病毒感染者中的定量检测

目的 定量检测慢性乙型肝炎(CHB)、乙型肝炎肝硬化(LC)、肝细胞癌(HCC)患者HBV总DNA(tDNA)、HBV共价闭合环状DNA (cccDNA)和HBsAg,并探讨其特点.方法 荧光定量PCR检测21例CHB、23例LC和25例HCC患者外周血和肝组织标本HBV tDNA、HBVcccDNA,化学发光法定量检测外周血HBsAg.正态数据采用ANOVA分析和t检验,相关性分析采用Pearson检验,非正态数据采用秩和检验.结果 在CHB、LC和HCC患者中,外周血HBVtDNA分别为(5.38±2.08)、(4.96±1.65)和(4.18±0.91)lg拷贝/mL,肝组织HBV tDNA分别为(7.18±1.91)、(6.51±1.87)和(5.87±1.47)lg拷贝/μg,肝组织HBV cccDNA分别为(3.53±2.03)、(2.63±2.13)和(0.58±1.40)lg拷贝/μg,外周血H BsAg分别为(3.30±0.65)、(3.12±0.52)和(2.60±1.03)lg IU/mL,CHB与HCC患者比较,差异均有统计学意义(t=2.446,P=0.013;t=2.562,P=0.014;t=5.799,P＜0.01;t=2.709,P=0.003),LC与HCC患者肝组织HBVcccDNA及HBsAg定量比较,差异有统计学意义(t=-3.894,P＜0.01;t=-2.237,P=0.023).外周血均未检出HBV cccDNA.HBsAg定量与外周血HBV tDNA(r=-0.290,P=0.016)、肝组织HBV tDNA(r=0.372,P=0.002)及肝组织HBV cccDNA(r=0.378,P=0.001)均有关.结论 HBV tDNA、HBV cccDNA、HBsAg在CHB、LC、HCC患者呈逐渐降低趋势,HBsAg定量与外周血HBV tDNA、肝组织HBV tDNA及肝组织HBV cccDNA有关.