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。     

慢性乙型肝炎患者B7-H1和PD-1信号途径表达的特点

目的 初步探讨免疫细胞协同共刺激分子途径之一--B7-H1和PD-1表达在慢性乙型肝炎(CHB)患者中的特点.方法 收集11例CHB患者和16例健康人的外周血肝素抗凝标本,流式细胞技术检测CHB患者外周血髓样树突细胞(mDC)和T淋巴细胞上B7-H1和PD-1的表达.数据比较采用t检验.结果 CHB患者外周血CD3~+T淋巴细胞、CD4~+T淋巴细胞、CD8~+T淋巴细胞和mDC上B7-H1阳性表达率分别为(40.69±14.49)%、(42.84±11.19)%、(33.48±14.07)%和(16.60±4.04)%.健康对照者分别为(14.66±10.11)%、(4.62±3.84)%、(1.89±2.31)%和(0.49±0.37)%,CHB患者B7-H1在T淋巴细胞和mDC上的表达水平均明显高于健康者,差异具有统计学意义(t=-2.884,t=-10.894,t=-7.378,t=-13.182;均P<0.05).CHB患者CD3~+T淋巴细胞、CD4~+T淋巴细胞和CD8~+T淋巴细胞上PD-1阳性表达率分别为(12.45±6.36)%、(11.42±6.20)%和(13.03±6.71)%,健康对照者分别为(7.80±3.53)%、(7.12±2.60)%和(7.88±3.74)%.CHB患者PD-1在T淋巴细胞上的表达水平也均明显高于健康者,差异具有统计学意义(t=-2.323,t=-2.355,t=-2.439;均P<0.05).结论 B7-H1和PD-1在CHB患者外周血mDC和T淋巴细胞上表达较高.     

聚乙二醇干扰素与普通干扰素对慢性乙型肝炎患者外周血CD4~+CD25~(high)T淋巴细胞变化的影响

目的比较聚乙二醇干扰素(PEG-IFNα-2a)与普通干扰素(IFNα-2b)抗病毒治疗对慢性乙型肝炎(CHB)患者外周血CD4~+CD25~(high)T淋巴细胞变化的影响。方法收集2012年6月-2015年6月于苏州市第五人民医院接受干扰素抗病毒治疗的HBeAg阳性CHB患者72例,按照患者自主选择的治疗方法分为PEG-IFNα-2a组(n=40)和IFNα-2b组(n=32),干扰素抗病毒疗程至少1年。采集治疗前和治疗12个月时的抗凝外周静脉血。另选取同期30例健康人作为对照。用流式细胞技术检测外周血CD4~+CD25~(high)T淋巴细胞的百分率。符合正态分布的计量资料多组间比较采用单因素方差分析;不符合正态分布的计量资料两独立样本比较采用Mann-Whitney U检验,配对资料比较采用Wilcoxon秩和检验。计数资料组间比较采用χ~2检验或Fisher确切检验。结果治疗12个月时,IFNα-2b组和PEG-IFNα-2a组的有效病例数分别为26例和32例。两组患者ALT复常率、HBeAg血清学转换率及HBV DNA阴转率比较,差异均无统计学意义(P值分别为0.05、0.05、0.47)。治疗前,IFNα-2b组和PEGIFNα-2a组外周血CD4~+CD25~(high)T淋巴细胞水平均显著高于健康对照组(U值分别为235.5、238.0,P值均0.05)。干扰素治疗12个月时,PEG-IFNα-2a组CD4~+CD25~(high)T淋巴细胞水平降低,与治疗前相比差异有统计学意义(Z=-2.515,P=0.012)。在获得HBeAg血清学转换的患者中,IFNα-2b组和PEG-IFNα-2a组比治疗前基线均显著降低(U值分别为121.0、204.5,P值均0.05),而两组之间差异无统计学意义(P0.05),且与健康对照组比较差异亦均无统计学意义(P值均0.05)。结论干扰素抗病毒治疗可以降低CHB患者外周血CD4~+CD25~(high)T淋巴细胞频率,PEG-IFNα-2a对CD4~+CD25~(high)T淋巴细胞的下调作用比IFNα-2b更强,但对于治疗获得HBeAg血清学转换的患者,两类干扰素的下调作用没有呈现出显著性差异。     

IFNα-2a对乙型肝炎患者外周血细胞毒性T淋巴细胞CD95表达及其凋亡率影响的实验研究

探讨IFNα-2a对乙型肝炎患者外周血细胞毒性T淋巴细胞(CTL)CD95表达及其凋亡率的影响。分离 26例乙型肝炎患者(其中慢性乙型肝炎16例,慢性重型乙型肝炎10例)和20例健康献血员外周血单个核细胞 (PBMC),在IFNα-2a作用前后通过流式细胞仪分别检测PBMC中CTL CD95的表达及其凋亡率。结果表明,乙型肝炎患者外周血CTL存在活化诱导的细胞死亡(AICD)现象,而IFNα-2a对乙型肝炎患者外周血CTL CD95表达及 CTL凋亡率并无影响。     

调节性T淋巴细胞对成人乙型肝炎疫苗接种免疫应答的影响

目的 通过对乙型肝炎疫苗接种后不同免疫应答人群调节性T淋巴细胞(Treg细胞)Foxp3 mRNA的表达和细胞因子分泌的检测,探讨乙型肝炎疫苗接种后免疫应答与免疫调节细胞和细胞因子之间的内在联系.方法 采集不同反应人群全血,实时荧光定量PCR检测人外周血单个核细胞Foxp3 mRNA的表达;流式细胞术对外周血单核细胞的表面标志物CD4、CD25进行检测;酶联免疫法检测外周血单个核细胞植物血凝素(PHA)和HBsAg刺激后白细胞介素(IL)-4、IL-12、IL-18、干扰素(IFN)γ的产生水平.根据不同资料采用方差分析、q检验或相关分析进行统计学处理.结果 (1)PHA和HBsAg刺激前后,无应答组Foxp3的表达均高于应答组和对照组,差异有统计学意义(P＜0.05).(2)应答组外周血CD4+CD25+Treg细胞占CD4+T淋巴细胞的百分比(0.59%±0.46%)明显低于对照组(1.30%±1.44%),差异有统计学意义(F=2.990,P＜0.01).(3)各组外周血单个核细胞经PHA和HBsAg刺激后,无应答组的IFN γ浓度[(11.00±9.03)U/ml]明显低于应答组[(38.88±28.16)U/ml],差异有统计学意义(P＜0.01).(4)各组外周血单个核细胞经PHA和HBsAg刺激后,IL-18、IL-4、IL-12的浓度差异均无统计学意义.结论 CD4+CD25+Foxp3+Treg细胞在一定程度上参与了乙型肝炎疫苗接种应答的负性调控;乙型肝炎疫苗接种后无应答与IFN γ分泌不足有关;抗-HBs滴度水平与IFN γ和CD4+CD25+Foxp3表达无相关性.     

microRNA-18a通过PPARα/γ信号通路上调慢性乙型肝炎患者调节性免疫功能

目的分析microRNA-18a(miRNA-18a)通过过氧化物酶体增殖物激活受体α/γ(PPARα/γ)信号通路对慢性乙型肝炎患者调节性免疫功能的影响。方法纳入空军特色医学中心(原中国人民解放军空军总医院)2017年4月-2018年10月98例慢性乙型肝炎患者和96例非乙型肝炎患者分别作为试验组和对照组。实时荧光定量聚合酶链反应检测2组患者血清中的miRNA-18a mRNA的相对表达量;流式细胞技术检测人外周血单个核细胞中miRNA-18a的表达;酶联免疫吸附试验检测miRNA-18a对CD4~+CD25~+调节性T淋巴细胞(Treg)相关细胞因子分泌水平的影响;Western Blot检测2组患者PPARα/γ信号通路相关蛋白表达。再将PBMC分为si-miRNA-18a抑制组(转染miRNA-18a抑制剂)和si-miRNA-18a正常对照组(转染miRNA-18a质粒),用流式细胞技术检测抑制miRNA-18a表达对CD4~+CD25~+Treg细胞频率的影响,Western Blot检测2组PPARα/γ信号通路相关蛋白的表达。正态分布的计量资料2组间比较采用t检验。Pearson相关分析检验miRNA-18a表达与PPARα/γ信号通路相关蛋白的相关性。结果试验组miRNA-18a mRNA表达水平在血清和肝组织中较对照组均显著上调(t值分别为9.634、9.863,P值均0. 01)。试验组CD4~+CD25~+Treg细胞频率较对照组显著上调(t=9.854,P0. 01)。试验组的IFNγ分泌水平和IL-9分泌水平较对照组均明显上调(t值分别为8.235,8.382,P值均005)。试验组的PPARα和PPARγ表达水平较对照组均明显上调(t值分别为4.229、3.545,P值均0. 05)。si-miRNA-18a抑制组外周血CD4~+CD25~+Treg细胞占CD4~+T淋巴细胞的比例明显低于si-miRNA-18a正常对照组(t=3.968,P0. 01)。si-miRNA-18a抑制组的PPARα和PPARγ表达水平均明显较si-miRNA-18a正常对照组低(t值分别为5.023、4.983, P值均0. 05)。miRNA-18a与PPARα/γ信号通路中的PPARα及PPARγ蛋白表达水平均呈正相关(r值分别为0.701、0.682,P值均0. 05)。结论 miRNA-18a可能通过激活PPARα/γ信号通路对慢性乙型肝炎患者调节性免疫功能产生影响,使其免疫功能相关细胞表面因子频率和细胞因子分泌水平上调。     

聚乙二醇干扰素α-2a对乙型肝炎病毒e抗原阳性慢性乙型肝炎患者记忆性CD8+T淋巴细胞CD127表达影响的动态研究

目的 观察聚乙二醇干扰索α-2a抗病毒治疗对HBeAg阳性慢性乙型肝炎患者记忆性CD8+T淋巴细胞CD127分子表达的影响.方法 30例HBeAg阳性慢性乙型肝炎患者接受聚乙二醇干扰素α-2a治疗,每周1次,共48周.根据CD45RA、CD27分子表达来判定记忆性CD8+T淋巴细胞,以流式细胞术检测CD127在CD8+T淋巴细胞上的表达.组间均数比较采用Mann-Whitney检验.结果 HBeAg阳性慢性乙型肝炎患者在CD45RA-CD27+记忆性CD8+T淋巴细胞上CD127的表达较健康对照组明显降低(Z=2.889,P＜0.05),其表达水平与血清HBV DNA水平和HBeAg呈负相关.聚乙二醇干扰素α-2a抗病毒治疗应答较佳者随着HBV DNA和HBeAg水平的下降,记忆性CD8+T淋巴细胞表面CD127分子的表达在治疗24、48和72周都明显增加,而应答欠佳者则无明显变化(Z24周=1.954,Z48周=2.789,Z72周=2.989;均P＜0.05).结论 慢性乙型肝炎患者通过有效的抗病毒治疗,CD8+T淋巴细胞表达CD127增加,CD127在记忆性CD8+T淋巴细胞上的表达水平可作为判定抗病毒治疗有效的重要标志.     

慢性乙型肝炎患者外周血及肝组织中CD4+CD25+调节性T细胞和乙型肝炎病毒特异性细胞毒性T淋巴细胞的表达及意义

目的 研究CD4+CD25+调节性T细胞和HBV特异性CTL在慢性乙型肝炎患者外周血和肝组织中的表达和临床意义.方法 流式细胞分析技术和流式细胞术细胞因子测定法(CFC)检测157例HBV感染者(包括急性乙型肝炎20例、慢性乙型肝炎115例、乙型肝炎肝硬化22例)和20例健康对照组外周血和部分肝组织中CD4+CD25+调节性T细胞和HBV特异性CTL的表达.组间分析采用t检验.结果急性乙型肝炎,慢性乙型肝炎轻、中、重度患者外周血中CD4+CD25+调节性T细胞分别为(2.87±0.94)%、(3.53±1.56)%、(4.59±2.98)%和(3.65±1.73)%,明显高于对照组的(2.36±0.60)%(t值分别为2.04、5.97、3.30和3.17,P<0.01);慢性乙型肝炎轻、中、重度和乙型肝炎肝硬化患者外周血HBV特异性CTL为(0.189土0.152)%、(0.103±0.110)%、(0.118±0.120)%和(0.098±0.101)%,明显低于急性乙型肝炎患者的(0.815±0.360)%(t值分别为10.09、11.87、9.17和8.96,P<0.01).肝组织中CD4+CD25+调节性T细胞和HBV特异性CTL的表达高于外周血.结论 CD4+CD25+调节性T细胞可能通过抑制CD8+T淋巴细胞在机体抗病毒过程中发挥重要作用.     

乙型肝炎患者外周血CD4+ CD25+调节性T细胞表型与功能分析

目的 观察急、慢性乙型肝炎(AHB、CHB)患者外周血CD4+CD25 high调节性T细胞(Treg)的频率、表型和功能特点.方法 采集16例AHB急性发病期(发病后第1周)患者、72例CHB患者和32例健康人的外周血,检测Treg频率,并分析其表面CD45RO、CD45RA、HLA-DR、CD95和细胞内细胞毒T淋巴细胞相关抗原4(CTLA-4)的表达水平.应用实时荧光定量RT-PCR检测CD4+ CD25+、CD4+ CD25-、CD4+和CD4-等细胞亚群和外周血单个核细胞(PBMC)的FoxP3 mRNA表达量.通过MACS免疫磁珠分选Treg,并应用[3H]掺入法检测Treg抑制抗-CD3抗体和HBV抗原刺激的PBMC增殖能力,并观察Treg对HBV抗原或抗-CD3抗体刺激自体PBMC分泌IFNγ的影响.结果 CD4+CD25 high Treg高表达CD45RO、HLA-DR、CD95和细胞内CTLA-4,低表达CD45RA,并且较特异的高表达FoxP3 mRNA.乙型肝炎病人外周血Treg频率与健康对照(3.50±0.72)%比较无统计学差异,但CHB组(3.90±1.44)%显著高于AHB组(3.10±0.87)%,P＜0.05.Treg本身对于HBV抗原或抗-CD3抗体刺激没有明显的增殖反应和IFNγ分泌,但可抑制自体PBMC增殖和IFNγ分泌,其中对HBV抗原刺激引起的细胞反应抑制作用较强.结论 HBV感染者外周血Treg较特异地表达FoxP3分子,能抑制HBV抗原特异性细胞免疫反应,这对于深入阐明CHB发病机制具有重要意义.     

HBeAg导致慢性乙型肝炎患者外周血Th1/Th2型细胞因子失衡

目的 探讨HBeAg对慢性乙型肝炎(CHB)患者外周血单个核细胞(PBMC)功能的调节作用. 方法 以重组的HBeAg体外刺激CHB患者和健康志愿者的PBMC,用流式细胞术和酶联免疫吸附试验法检测其刺激前后Th1/Th2型细胞因子的变化情况,并观察HBeAg对CHB患者PBMC表面细胞程序性死亡受体(PD)1及其配体(PD-L)1表达的影响.两组间资料比较采用独立样本t检验; PD-1/PD-L1表达水平与HBV DNA拷贝数的相关性采用Spearman相关分析.结果 HBeAg刺激后可使HBeAg阴性CHB患者和健康志愿者CD3+CD4+T淋巴细胞内干扰素(IFN)γ表达水平(0.17％±0.08％与0.17％±0.04％)明显低于未刺激组(0.30％±0.16％与0.32％±0.12％),t值分别为-2.382和-4.190,P值均＜0.01;培养上清液中白细胞介素(IL)-6、IL-10和肿瘤坏死因子α含量明显高于未刺激组(HBeAg阴性CHB患者的t值分别为2.504,3.583和4.324,健康志愿者t值分别为3.542,6.246和5.273,P值均＜0.01).HBeAg刺激PBMC后,HBeAg阴性CHB患者和健康志愿者CD14+细胞表面PD-L1表达水平分别为13.02％±4.98％和3.10％±2.47％,明显高于未刺激组的5.89％±1.56％和0.97％±0.83％,t值分别为4.815和3.454,P值均＜0.05.基础状态下在HBeAg阳性CHB患者外周血中,CD3+CD4+T淋巴细胞内IFNγ表达水平为0.23％±0.09％,明显低于HBeAg阴性CHB患者和健康志愿者的0.34％±0.15％和0.35％±0.09％(t=-3.177,P＜0.01 ; t=-4.541,P＜0.01);而IL-4表达水平为0.39％±0.16％,明显高于HBeAg阴性CHB患者和健康志愿者的0.26％±0.12％和0.23％±0.12％,t值分别为3.382和4.393,P值均＜0.01.基础状态下在HBeAg阳性CHB患者外周血中,CDB+T淋巴细胞表面PD-1和PD-L1表达水平明显高于HBeAg阴性CHB患者及健康志愿者(P值均＜ 0.01),CD14+T淋巴细胞表面PD-L1表达水平显著高于HBeAg阴性患者和健康志愿者,t值分别为5.092和5.473,P值均＜0.01 ; HBeAg阴性CHB患者外周血中CD3+T淋巴细胞表面PD-L1表达水平明显高于健康志愿者(t=3.214,P＜0.01).结论 HBeAg可以明显抑制Th1型细胞因子IFN γ的产生,促进Th2型细胞因子IL-6和IL-10分泌,上调外周血PBMC表面PD-1/PD-L1的表达,从而有利于形成对HBV感染的免疫耐受.因此,HBeAg可能是造成慢性HBV感染者体内免疫耐受的重要因素之一.     

Peg-interferon improves liver histology in patients with HBeAg-positive chronic hepatitis B: no additional benefit of combination with lamivudine.

BACKGROUND: The effect of pegylated interferon or its combination with lamivudine on liver histology of patients with chronic hepatitis B (CHB) is unknown. In a double-blinded, randomized, multi-center study we assessed histological changes in 110 hepatitis B e-antigen (HBeAg)-positive CHB patients treated for 52 weeks with Pegylated interferon alpha-2b (PEG-IFN) in combination with either lamivudine or placebo. Liver biopsies were taken before and at the end of treatment. All biopsies were blinded and scored according to the Ishak system. RESULTS: Necroinflammatory score improved (defined as a decrease of at least two points) in 25 patients (48%) of the PEG-IFN/lamivudine combination therapy group and in 31 patients (53%) of the PEG-IFN monotherapy group. The fibrosis score improved (decrease of at least 1 point) in 17 patients (33%) of the combination therapy group vs. 13 patients (22%) of the PEG-IFN monotherapy group (P=0.23). Responders (n=42), defined as serum HBeAg negative at the end of therapy, showed a larger decline in necroinflammatory score than non-responders (mean decline 2.3 and 1.2 points, respectively, P=0.02). Among patients receiving PEG-IFN monotherapy necroinflammation improved more frequently in responders (78% of responders vs. 43% of non-responders, P=0.01) and in patients who showed normalization of ALT (76% of patients with normal ALT vs. 40% of patients with abnormal ALT, P=0.01). Fibrosis score in the PEG-IFN monotherapy group improved more often in responders (39%) than in non-responders (15%, P=0.04). In the PEG-IFN/lamivudine combination therapy group, we found no significant association between virological and biochemical endpoints and histological improvement. CONCLUSIONS: Treatment with PEG-IFN therapy improves liver necroinflammation in HBeAg-positive CHB patients, particularly in responders to therapy. PEG-IFN also improves fibrosis in responders. Addition of lamivudine to PEG-IFN did not further improve the histological outcome.     

Study of human B7 homolog 1 expression in patients with hepatitis B virus infection

AIM: To further investigate the role of human B7 homolog 1 (B7-H1) in the mechanism of persistent hepatitis B virus (HBV) infection. METHODS: Peripheral and intra-hepatic B7-H1 expression were compared by flow cytometry and immunochemical staining between two 2 distinct groups, one being chronic HBV tolerance patients (CHB-T) and the other being acute hepatitis B patients (AHB). B7-H1 mRNA expression level was also compared by real time polymerase chain reaction between CHB-T and AHB patients. The location of intra-hepatic B7-H1 and CD40 expression were analyzed by immunofluorescence. The levels of B7-H1 and CD40 expression on cultured myeloid dendritic cells (mDCs) with or without hepatitis B surface antigen (HBsAg) treatment were analyzed dynamically by flow cytometry. Intracellular interferon-γ (IFN-γ) staining and the stimulatory capacity of mDC of cultured mDC with or without HBsAg treatment were also compared by flow cytometry. RESULTS: Peripheral B7-H1 expression on mDCs was increased significantly in AHB compared to CHB-T patients (P 0.05). In the liver tissues from CHB-T patients, B7-H1 positive cells were almost absent despite a persistently elevated serum HBsAg load. In contrast, there were indeed increased B7-H1-positive cells in situ in the liver tissue from AHB. In vitro analysis showed the parallel upregulation of B7-H1 and CD40 on CD11c+ mDCs after the onset of stimulation. Addition of recombinant hepatitis B surface antigen (rHBsAg) significantly decreased CD40 expression (P 0.05 at 16 h, 20 h and 24 h time points). B7-H1 expression was also inhibited by rHBsAg, and the inhibition rate of CD40 was greater than that of B7-H1. This preferential inhibition of CD40 expression on mDCs by rHBsAg resulted in the dysfunction of mDCs and T cells in the mixed leucocyte reaction (MLR) system. With rHBsAg pretreatment, in a carboxyfluorescein diacetate succinimidyl ester (CFSE) labeled MLR system at a ratio of 1:5 responder cell-stimulator cell (R/S), the CFSE dim percentage of T cells decreased from 85.1% to 25.4% and decreased from 30.3% to 12.0% at 1:10 R/S. IFN-γ production by CD8+ T cells, in the MLR system, was reduced significantly by HBsAg pretreatment. At ratios of 1:5 R/S, the percentage of IFN-γ and CD8 dual positive T cells decreased from 55.2% ± 5.3% to 15.1% ±3.1% (P 0.001), and decreased from 35.0% ± 5.1% to 7.3% ± 2.7% at ratios of 1:10 R/S (P 0.001). CONCLUSION: B7-H1 is not a signature of immune dysfunction, but an inflammation marker. HBsAg regulate immune response by tipping the balance between B7-H1 and CD40.     

Viral suppression correlates with dendritic cell restoration in chronic hepatitis B patients with autologous cytokine‐induced killer cell transfusion

Background: Myeloid and plasmacytoid dendritic cells (mDCs, pDCs) are functionally impaired in patients with chronic hepatitis B (CHB). Adoptive immunotherapy can suppress hepatitis B virus (HBV) replication in CHB patients, but whether it can restore the functionality of mDCs and pDCs remains unknown. Methods: Autologous cytokine‐induced killer (CIK) cells obtained from 14 CHB patients were transfused back to patients, case by case, to observe the effect of CIK‐cell treatment on the frequency and functionality of mDCs and pDCs in CHB patients during a 24‐week follow‐up investigation. Results: Seven virological responders exhibited a sustained decrease in HBV load after CIK‐cell transfusion; another seven non‐virological responders showed only sustained high levels of HBV load during the 24‐week period following CIK‐cell transfusion. The rate of hepatitis B e antigen loss or seroconversion was also higher in virological responders than in non‐virological responders. Importantly, we found that the frequency and cytokine‐producing capacity of mDCs and pDCs increased significantly in virological responders, but not in non‐virological responders. In addition, these patients exhibited a close correlation between restoration DC subsets and a decrease in HBV DNA load, rather than a change in the alanine aminotransferase level. Conclusion: Cytokine‐induced killer‐cell treatment reduced HBV DNA load in some CHB patients; the efficiency at least partially correlates with the restoration of frequency and functionality of mDCs and pDCs.     

Serum proteins in chronic hepatitis B patients treated with peginterferon alfa-2b

AIM: To study the differential protein profile in serum of hepatitis B patients.METHODS: Serum samples were obtained from patients with chronic hepatitis B who were receiving peginterferon alfa-2b.The serum samples were subjected to albumin depletion and analyzed by two-dimensional gel electrophoresis(2-DE).Differentially expressed protein spots were identified by electrospray ionizationquadrupole time-of-flight mass spectrometry.Alpha2-HS-glycoprotein,complement component C3c and CD5 antigen were further analyzed by an enzymelinked immunosorbent assay and immunonephelometry.RESULTS: Nineteen patients with HBeAg-positive chronic hepatitis B(CHB) were studied.These patients were followed for at least 1 year after treatment and were classified according to their treatment response: responders(n = 9) and non-responders(n = 10).2-DE and MS/MS analysis were performed to compare the serum proteins before initiating peginterferon alfa2b.From the quantitative analysis of the 2-D gel,7 proteins were detected between the two groups at different levels before treatment.Among these potential candidates,serum levels of alpha-2-HS-glycoprotein,complement component C3c and CD5 antigen-like precursor were further analyzed.In the validation phase,23 subjects,9 sustained responders and 14 nonresponders,were recruited.Interestingly,the levels of alpha-2-HS-glycoprotein and complement component C3c were elevated in the serum of the non-responders compared to the responders.CONCLUSION: Serum alpha-2-HS-glycoprotein and complement component C3c may be potential serum biomarkers in predicting the treatment response of peginterferon alfa-2b in patients with CHB prior to treatment.     

细胞因子诱导的自体杀伤细胞回输治疗慢性乙型肝炎患者树突状细胞功能的研究

目的了解细胞因子诱导的自体杀伤（CIK）细胞回输治疗是否能恢复慢性乙型肝炎（CHB）患者树突状细胞（DC）的功能。方法12例CHB患者应用CIK细胞回输治疗,入组前6个月至CIK细胞治疗随访期间,患者未接受任何抗病毒及免疫调节治疗。观察24周后患者髓样树突状细胞（mDC）、浆细胞样树突状细胞（pDC）比例和功能变化,并对其变化结果进行分析。结果应用CIK细胞回输治疗24周后,病毒载量下降≥2个log或转阴的患者外周血mDC、pDC功能明显提高。病毒学应答患者（n=6）病毒载量下降水平与外周血DC功能的恢复密切相关。结论CHB患者接受CIK细胞回输治疗可以提高外周血mDC和pDC功能。     

Response to interferon-alpha treatment correlates with recovery of blood plasmacytoid dendritic cells in children with chronic hepatitis B

BACKGROUND/AIMS: To investigate whether dendritic cell changes are associated with the efficacy of interferon-alpha treatment we longitudinally analyzed circulating dendritic cells in children chronically infected with hepatitis B virus (HBV) undergoing interferon-alpha treatment. METHODS: Thirty-one children with chronic hepatitis B (CHB) received interferon-alpha antiviral treatment for 52 weeks. Myeloid and plasmacytoid dendritic cell (pDCs) frequency and function were analyzed at weeks 0, 2, 12, 24, 36 and 52 in 22 CHB patients. RESULTS: All patients exhibited an initially rapid decrease of circulating pDC numbers and CpG-induced endogenous interferon-alpha production within 2 weeks of interferon-alpha treatment. Subsequently, all responders displayed a continuous increase of both pDC numbers and function peaking around week 12. These responses were consequently accompanied by viral clearance, hepatitis B e antigen seroconversion, and the improvement of circulating myeloid dendritic cells and type 1T helper cytokine levels. However, non-responders lacked these sequential responses compared with responders. CONCLUSIONS: pDCs may actively correlate with interferon-alpha therapy-induced viral clearance in pediatric patients with CHB. The recovery of blood pDC number and function may represent a prognostic marker for favourable response to interferon-alpha treatment in chronic hepatitis B.     

慢性乙型肝炎患者抗病毒治疗早期T细胞表面PD-1的表达

背景：慢性乙型肝炎病毒（HBV）感染者T细胞表面程序性死亡受体1（PD-1）呈持续性高表达。然而关于抗病毒治疗前后慢性乙型肝炎（CHB）患者T细胞表面PD-1表达变化及其与病毒载量关系的报道较少。目的：动态观察CHB患者抗病毒治疗早期外周血CD4＋和CD8＋T细胞表面PD-1表达水平,探讨其表达与血清HBV DNA载量和丙氨酸氨基转移酶（ALT）水平之间的关系。方法：以流式细胞术分别检测31例CHB患者抗病毒治疗前或基线期（T1）、治疗后4～8周（他）和12．16周（T3）的外周血CD4^＋和CD8^＋T细胞表面PD-1表达水平,以实时荧光定量聚合酶链反应（PCR）检测血清HBV DNA载量,同时检测血清ALT水平。结果：抗病毒治疗早期,CHB患者外周血CD4^＋和CD8^＋T细胞表面PD．1表达水平逐渐下调（P〈0．05）,血清HBV DNA载量和ALT水平亦逐步降低（P〈0．01）;CD4^＋和CD8^＋T细胞表面PD-1表达与HBV DNA载量（P〈0．01）和ALT水平（P〈0．05）均呈正相关。结论：有效的抗病毒治疗可通过降低CHB患者的病毒载量使T细胞表面PD-1表达下调,T细胞表面PD-1表达水平与患者疾病状态密切相关。     

B7-H1 is up-regulated in HIV infection and is a novel surrogate marker of disease progression

The ligation of programmed death-ligand 1 (B7-H1) to T cells results in the preferential production of interleukin 10 (IL-10). We investigated if B7-H1 would be up-regulated in HIV infection, a disease characterized by increased IL-10 production, by measuring B7-H1, B7-1 (CD80), and B7-2 (CD86) expression and mRNA in 36 HIV-infected patients and in 22 healthy controls (HCs). Results showed that (1) B7-H1 expression and mRNA are augmented in cells of HIV patients; (2) increased IL-10 production in these patients is largely induced by B7-H1-expressing CD14(+) cells; (3) an inverse correlation is detected between B7-H1 expression and CD4 counts, whereas the up-regulation of B7-H1 is directly associated with HIV plasma viremia; (4) antiviral therapy results in the parallel down modulation of IL-10 production and B7-H1 expression/synthesis; and (5) B7-H1/CD80 and B7-H1/CD86 mRNA ratios are increased in peripheral blood mononuclear cells (PBMCs) of HIV patients compared with HCs. B7-H1 synthesis and expression are up-regulated in HIV infection, and the degree of dysregulation correlates with the severity of disease. Aberrant antigen presentation by antigen-presenting cells (APCs) that exhibit increased B7-H1 expression and IL-10 production in HIV infection could be responsible for T-lymphocyte unresponsiveness and loss of protective immunity. B7-H1 is a surrogate marker potentially involved in AIDS disease progression.