乙肝患者针对抗-HBs的抗独特型体液和细胞免疫反应

目的探讨针对抗-HBs分子上独特型决定簇的攸液及细胞免疫反应的免疫调节意义。方法采用淋巴细胞转化试验观察在急性和慢性乙肝患者体内针对抗-HBs分子上独特型抗原决定簇的体液及细胞免疫反应，并与患者对HB-sAg的体液及细胞免疫反应进行对比。结果25例AVH患者，针对肝HBsAg的体液及细胞免疫反应明显延迟。针对表面抗体的体液及细胞免疫反应．在1wk已达到较高水平，维持4～6wb后逐渐下降。31例CAH，机体对HBsAg的体液及细胞免疫反应明显低下或缺乏。而抗独特型抗体(Ald)阳性单明显高于其它组，且针对抗-HBs独特型的LTT反应也十分活跃。结论这种针对抗-HBs独特型的免疫反应可能涉及一种是缺陷的反馈抑制，导致抗-HBs的产生抑制及HBV携带者状态的维持。

Anti-idiotypic humoral and celluar response to anti-HBs in hepatitis B patients

To research the regulatory significance of humoral and celluar response to the idiotype deter-minants on the anti-HBs.Method Using lymphocyte transformation test (LTT), humoral and celluar response to he Ald anti -HBs were investigated and comared with humoral and celluar response of the same patients to HBsAg.Results ln 25 cases AVH, the humoral and cellu ar responses to HBsAg were cleary delayed. The.hunoral and celluar responsed to anti-HBs have reached a high level in the first week of the onset of clinical symptoms. This level kept for 4~6 weeks and then went down gradually. 31 cases of CAH showed a poor humoral and celluar response to HBsAg, however the prevalance of anti-Id antitbodies is cleary higher than other groups and the LTT. to the idiotype of anti -HBs showed very activity.Conclusion The anti-idiotype directed against anti-HBs may be invoved in a defective feedback mechanism resulting in the supppresion of predution of anti-AN and maintenance of the carrier state.