慢性乙型肝炎患者外周血树突状细胞内HBcAg存在与肝组织学改变的关系

目的 在证实外周血单核细胞诱导的树突状细胞（dendriticcell，DC）中存在HBV的基础上，研究树突状细胞中存在HBcAg与肝组织学改变的关系。方法 通过对24例慢性乙型肝炎患者和8例健康对照者外周血单核细胞诱导树突状细胞，采用流式细胞仪检测树突状细胞共刺激分子（CD80／CD86／CD40／CD54）等表达情况，并结合患者肝组织病理改变评价结果进行比较。结果 慢性乙型肝炎者树突状细胞的CD40、CD86表达率明显低于正常对照组（P〈0．01），CD80明显高于正常对照组（P〈0．01），而慢性乙型肝炎患者外周血树突状细胞中HBcAg阳性组和阴性组之间无明显差异（P〉0．05）。肝组织病理改变中，阴性组的汇管区炎细胞浸润、肝组织炎症总积分均显著高于阳性组（P〈0．05）。结论 乙肝病毒可能对外周血DC表达CD80、CD86、CD40等功能性共刺激分子有明显影响，而与DC内HBV的存在与否无明显关系；DC内HBcAg存在者肝组织炎症程度相对较轻。

The Relationship Between Liver Histological Change and Expression of HBcAg in Peripheral Blood Dendritic Cells in Patients with Chronic Hepatitis B

Objective To study the relationship between liver histological changes and expression of HBcAg in peripheral blood dendritic cells in patients with chronic hepatitis B.Methods The peripheral blood samples were obtained from 24 patients with chronic hepatitis B (CHB) and 8 healthy individuals.The peripheral blood mononuclear cells (PBMCs) were isolated.DCs were isolated from peripheral blood mononuclear cells and enriched by culturing with recombinant human interleukin 4(rhIL-4) and recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF),then DCs were harvested and the costimulators of CD80,CD86,CD40 and CD54 on DCs were tested by immunofluorescence flow cytometry.These costimulators were compared with liver histological changes.Results Percentage of CD40 and CD86 was significant lower than that of healthy donors(P<0.01),but percentage of CD80 was significant higher(P<0.01).There was not statistical difference between DC HBcAg positive group and negative group.About liver histological changes,the percentage of inflammatory cellular infiltration in portal venous and total inflammatory score in HBcAg negative group was significant higher than those in HBcAg positive group (P<0.05).Conclusions HBV may exert important influence on the expression of the costimulators of CD80,CD86,CD40 on DCs,without relationship to presence of HBV in DCs.The inflammatory grade is not more serious with presence of HBcAg in DCs.