慢性丙型肝炎患者外周血Cbl-b、CD28和CTLA-4的表达及其临床意义

目的探讨慢性丙型肝炎患者外周血E3泛素连接酶Cbl—b及其相关信号分子CD28和CTLA一4的变化规律及其临床意义。方法选择25例慢性丙型肝炎患者和19例健康对照者，分离外周血单个核细胞，应用tit—PCR法检测Cbl—b、CD28和CTLA-4mRNA相对表达水平；采用荧光定量RT—PCR检测HCVRNA；采用IN—NO—LiPA线性探针杂交法检测HCV基因分型。结果Cbl—b、CD28和CTLA-4mRNA在慢性丙型肝炎患者中表达升高，较健康对照分别升高1．38倍、1．90倍和2．68倍，其中CTLA4—4的升高表达具有统计学意义（P〈0．05）；在HCV1b基因型（n=11）中，Cbl—b和CTLA-4mRNA水平较HCV2a基因型（n=14）显著升高，分别升高1．74倍和2．81倍，差异具有统计学意义（P〈0．05），而Cbl—b、CD28和CTLA-4水平与HCVRNA和AIJT水平均无显著相关性。结论Cbl—b和CTLA-4可能参与了HCV感染所致的机体免疫耐受，在HCV感染慢性化中发挥重要作用。

The expression of Cbl-b,CD28 and CTLA-4 in peripheral blood monouclear cells in patients with chronic hepatitis C

Objective To investigate the changes and clinical significance of E3 ubiquitin ligase Cbl-b and the related signaling molecules CD28 and CTLA-4 in patients with chronic hepatitis C.Methods 25 patients with chronic hepatitis C and 19 healthy persons were enrolled in this study.Peripheral blood monouclear cells(PBMC)were isolated.The related mRNA expressions of Cbl-b,CD28,and CTLA-4 were measured by RT-PCR;HCV RNA was detected by real-time RT-PCR;Genotyping of HCV was performed using a second generation INNO-LiPA line probe assay.Results The mRNA levels of Cbl-b,CD28,and CTLA-4 were increased in chronic hepatitis C,with 1.38-,1.90-,and 2.68-time higher than those in healthy controls,respectively;The expressions of Cbl-b and CTLA-4 mRNA were significantly increased in HCV genotype 1b(n=11) than those in HCV genotype 2a(n=14),with 1.74-and 2.81-time higher,respectively(P<0.05);There were no correlations between the levels of three molecules and HCV RNA,so as to the associations of those and ALT levels.Conclusion Cbl-b and CTLA-4 may take part in the immune tolerance induced by the HCV infection and play an important role in chronic HCV infection.