慢性乙型肝炎患者树突状细胞表型的研究

目的探讨慢性乙型肝炎患者外周血来源树突状细胞（Dendritic cell，DC）数量及表型的改变，并对其与肝功能、乙肝病毒复制水平的关系进行研究。方法检测37例慢性乙肝患者和21例健康人肝功能及血清HBV DNA水平，并提取外周血单个核细胞（Peripheral blood mononuclear cell，PBMC）进行体外诱导培养，促使其发育成DC，计数其数量并检测膜表面分子的变化。分析DC数量及表型与肝功能、乙肝病毒复制水平的关系。结果与正常对照组比较，慢性乙肝患者的树突状细胞数量明显减少（P〈0．05），且其膜表面分子CD83、CD86的表达均明显降低（P〈0．05）。在慢性乙肝患者中，DC数量、DC膜表面分子CD83和CD86与血清HBV DNA之间呈负相关关系，而与肝功能之间无明显相关关系。结论慢性乙肝患者体内存在DC数量减少及成熟障碍，这种改变与肝内炎症反应程度不相关，但与乙肝病毒（Hepatitis Bvirus，HBV）的复制水平呈负相关，提示DC参与慢性乙肝患者体内HBV的清除。

Phenotype of peripheral blood mononuclear cells derived dendritic cells from patients with chronic hepatitis B

BACKGROUND: The aim of this study was to access phenotype changes of dendritic cells (DC) cultured from peripheral blood mononuclear cells (PBMC) in patients with chronic hepatitis B and to reveal the relationship between phenotype of DC and ALT or HBV DNA. METHODS: Indices of ALT and serum HBV DNA were measured in 37 patients with chronic hepatitis B and 21 healthy controls. Peripheral blood mononuclear cells were isolated from all patients and healthy controls, and cultured with granulocyte-macrophage colony-stumilating factor (GM-CSF), interleukin-4 (IL-4) and tumor necrosis factor- (TNF-)in RPMI 1640 medium that contained 10% fetal calf serum. After culturing for 7 days, the DC was counted and the phenotypes were detected by FACS. Then the data were statistically analysed. RESULTS: The DC was significantly fewer (P less than 0.05) in patients with chronic hepatitis B than the controls. In particular, the expressive level of CD83 and CD86 on DC's surface from patients with chronic hepatitis B were also significantly lower (P less than 0.05) than that from the controls. In the patients with hepatitis B, the indices of DC had a significantly negative correlation with the level of serum HBV DNA (P less than 0.05), but no significant relationship was found between ALT and indices of DC (P greater than 0.05). CONCLUSION: The DC cultured from patients with chronic hepatitis B were few and had immature phenotype. These changes had a significantly negative correlation with the level of serum HBV DNA, but had not correlation with the inflammatory reaction levels in the liver. DC was associated with the clearance of HBV in patients with hepatitis B.