慢性乙型肝炎患者抗病毒治疗前后HBV特异性T细胞反应

目的观察慢性乙型肝炎(CHB)患者拉米夫定抗病毒治疗前后外周血HBV特异性T辅助细胞频率的变化及与血清HBVDNA的关系。方法用重组人HBcAg作为刺激抗原,采用酶联免疫斑点法(ELISPOT)检测25例CHB轻、中度患者外周血抗病毒治疗前后分泌IFNγ的HBV特异性T辅助细胞的频率。用即时定量荧光PCR仪定量检测患者血清HBVDNA水平。结果CHB轻、中度患者治疗前外周血HBV特异性T辅助细胞频率均值为(47.30±25.50)SFCs/1×106PBMC,拉米夫定抗病毒治疗3个月后显著降低(23.10±18.45SFCs/1×106PBMC,P<0.05)。动态观察的8例CHB轻、中度患者抗病毒治疗前HBV特异性T辅助细胞频率均高于治疗后;6例患者抗病毒治疗后血清HBVDNA水平显著降低,2例患者血清HBVDNA水平没有下降,血清HBVDNA水平下降的患者(除1例外)治疗前HBV特异性T辅助细胞频率高于血清HBVDNA水平没有下降的患者。结论炎症期CHB轻、中度患者HBV特异性T辅助细胞反应高于炎症缓解期。

Sequential analyses of circulating HBV specific T helper cell response in chronic hepatitis B patients receiving antiviral treatment

BACKGROUND: To investigate the frequency of circulating HBV specific T helper cell and evaluate its association with serum levels of HBV DNA before and during lamivudine treatment in patients with chronic hepatitis B. METHODS: The frequency of circulating HBV specific T helper cells in response to HBcAg in 25 chronic HBV-infected patients was determined by Elispot assay; serum HBV DNA was quantitated by real-time PCR. RESULTS: The frequency of HBV specific T helper cell before antiviral treatment (47.30 +/- 25.50 SFCs /1 x 10(6) PBMC) was significantly higher than that at the third month of therapy (23.10 +/- 18.45 SFCs /1 x 10(6) PBMC, P < 0.05). All 8 patients observed dynamically had decreased frequency of HBV specific T helper cell at the third month of therapy; six patients with serum HBV DNA level reduced had higher frequency of HBV specific T helper cell before treatment than 2 patients without serum HBV DNA level decrease. CONCLUSION: HBV specific T helper cell response at the time of hepatitis flare in chronic hepatitis B patients was significantly augmented compared to that at the time of catabasis.