慢性HBV感染者特异性细胞毒性T淋巴细胞及HLA-A2的变化研究

目的：探讨慢性HBV感染者特异性细胞毒性T淋巴细胞（specific cytotoxic T lymphocyte，CTL）及人类白细胞抗原一A2（human leucocyte antigen-A2，HLA-A2）的变化。并分析CTL与血清丙氨酸氨基转移酶（alanineaminotransferase，ALT）水平和病毒载量的关系，以了解慢性HBV感染者特异性细胞免疫功能的状态。方法：采用HLA-A2限制的HBVcore18-27抗原表位肽五聚体（MHC Pentamersl法结合流式细胞技术，分析CHB组慢性乙型肝炎46例、LC组乙型肝炎肝硬化29例和NC组23例正常对照健康体检者，外周血HBV特异性CTL及HLA-A2的变化，并分析CTL与ATL水平和病毒载量的关系。结果：CHB组、LC组HLA-A2检出率均明显高于NC组；ALT水平和病毒载量与HBV特异性的CTL有一定的关系。结论：采用HLA-A2限制的HBVcore18-27抗原表位肽五聚体（MHCPentamers）法结合流式细胞技术可以检测到低水平的HBV特异性CTL；HLA-A2是乙型肝炎肝硬化的易感基因之一；ALT水平和病毒载量与HBV特异性CTL有一定的关系。

Study of the changes of CTL and HLA-A2 in patients with chronic HBV infection

Objective： To investigate the changes of specific cytotoxic T lymphocytes（CTL）and HLA-A2 in patients with chronic HBV infection and to analyze the relationships between the CTL and ALT and HBV copies, all of which can facilitate us to understand the statue of specific cellular immunity functions in patients with chronic HBV infection. Meth- ods： Peripheral HBV specific CTL and HLA-A2 of 46 patients with chronic hepatitis B, 29 patients with chronic hepatitis B cirrhosis and 13 healthy examined people （as normal controls） were measured by HLA-A2 limited HB~ core 18-27 pep- tide pentamers combined with Flow Cytometry. The relationships between the CTL and ALT and HBV copies were anal- ysed. Results： The detection rate of patients with chronic hepatitis B and cirrhosis were higher than that of the normal con- trol group. The level of ALT and the amount of HBV copies were related closely to HBV specific CTL. Conclusion： The low level HBV specific CTL can be detected by the method we adopted, the HLA-A2 was one of the susceptibility genes for hepatitis B cirrhosis, and the level of ALT and the amount of HBV copies Were related closely to HBV specific CTL.