Fas、FasL在慢性乙型肝炎患者肝细胞和外周血淋巴细胞上的表达

探讨慢性乙型肝炎患者肝细胞及外周血淋巴细胞上Fas、FasL的表达与乙型肝炎病毒（HBV）复制水平及肝组织炎症程度的关系。对30例慢性乙型肝炎患者进行肝穿刺肝组织病理检查及免疫组化SP法检测肝细胞中Fas、FasL表达强度。并采用单克隆抗体经流式细胞仪检测外周血淋巴细胞上Fas、FasL表达阳性百分率；同时，采用荧光实时标记法测定血清中病毒复制指标HBV DNA水平；采用Beckman全自动生化分析仪检测肝功能并研究其相关性。慢性乙型肝炎患者肝细胞中Fas、FasL表达强度随肝组织炎症活动度加重而增强（P均〈0．001），与白蛋白及丙氨酸转移酶（ALT）呈负相关（P〈0．005，P〈0．001），与球蛋白、总胆红质无明显相关性（P均〉0．05）。外周血淋巴细胞上Fas、FasL的表达阳性率与血清中肝炎病毒复制指标HBV DNA水平呈正相关；与慢性肝炎分度无明显的相关性。乙型肝炎病毒感染可诱导肝细胞及外周血淋巴细胞上Fas、FasL的表达。肝细胞Fas、FasL的表达随炎症活动度加重而表达增强，但其介导的凋亡并不引起肝细胞炎症损伤即ALT活性并不升高，相反减少；同时在某种程度上影响白蛋白的合成。提示Fas—FasL介导的肝细胞凋亡是以非细胞损伤方式参与慢性乙型肝炎的发病过程。同时，随血清HBV DNA水平增高，外周血淋巴细胞上Fas、FasL的表达亦增强，淋巴细胞的凋亡因而增多，是导致乙型肝炎慢性化的原因之一。由此可见，Fas、FasL介导的凋亡参与了慢性乙型肝炎的发病机制，且在慢性乙型肝炎的发生发展中起重要作用。

Expression of Fas and FasL in the hepatocytes and peripheral blood lymphocytes from patients with chronic hepatitis B

To evaluate the correlation of the expression of Fas and Fas ligand(FasL) in the hepatocytes and peripheral blood lymphocytes(PBLs) with chronic hepatitis B(CHB) to the level of HBV replication and the degree of inflammation of the liver tissues.Liver biopsy samples from 30 cases with CHB were immunohistostained for Fas and FasL by Sp method with rabbit anti-Fas monoclonal antibody.PBLs were detected by flow cytometer with mouse monoclonal antibody.At the same time,the level of HBV DNA and hepatic function of the cases were detected.Hepatitis B virus induced the expression of Fas and FasL in hepatocytes and PBLs,The expression of Fas and FasL in hepatocytes was higher with the ingrade of inflammatory activity(P<0.001),and was negatively related to the value of albumin and alanine aminotransferase(P<0.005,P<0.001).But it was not related to globulin or total bilirubin.Both of Fas and FasL in the PBLs were positively correlated with the level of serial HBV DNA(P<0.001),and were not correlated with the degree of CHB(P>0.005).The expression of Fas and FasL in hepatocytes aggravated with the grade of inflammatory activity.But they did not contribute to hepatic lesion because alanine aminotransferase did not increase.To some extent,they affected hepatocytes to synthesize albumin.The higher level HBV DNA,the higher were the expression of Fas and FasL in PBLs.This leaded lymphocytes to decrease and could not to eliminate HBV.So Fas-FasL mediated apoptosis,contributed to pathogenesis of CHB,and might play an important role on the progression of CHB.