急性戊型肝炎病毒感染后免疫状态及转归

目的：探讨急性戊型肝炎病毒感染后免疫状态的变化及转归.方法：采用双抗体酶联分析法检测急性戊型肝炎病毒感染患者不同时期外周血细胞因子IFN-γ,IL-4和IL-12的水平; 流式细胞仪免疫荧光法检测急性戊型肝炎病毒感染患者T淋巴细胞亚群细胞含量.结果：观察结束时,96例抗-HEVIgM转阴,14例未转阴.急性戊型肝炎抗-HEVIgM转阴患者,急性期IL-12,IFN-γ,IL-4和Th1/Th2水平、CD3＋,CD4＋和CD4＋/CD8＋细胞亚群比例明显升高（P〈0.05）; 恢复期IL-12,IFN-γ,IL-4和Th1/Th2水平、CD3＋,CD4＋和CD4＋/CD8＋细胞亚群比例明显降低（P〈0.05）.急性戊型肝炎抗-HEVIgM未转阴阳性患者,急性期IL-12,IFN-γ,IL-4和Th1/Th2水平、CD3＋,CD4＋和CD4＋/CD8＋细胞亚群比例明显升高（P〈0.05）,而CD8＋细胞亚群比例无明显变化; 恢复期IL-12、IFN-γ和Th1/Th2水平、CD3＋,CD4＋和CD4＋/CD8＋细胞亚群比例明显降低（P〈0.05）,且Th1/Th2水平、CD4＋/CD8＋细胞亚群比例低于对照组,但IL-4水平、CD8＋细胞亚群比例明显升高,且明显高于对照组（P〈0.05）.结论：急性戊型肝炎抗-HEVIgM未转阴阳性患者,恢复期持续高水平的IL-4不利于疾病恢复,Th1/Th2细胞的失衡可能是戊型肝炎病毒持续感染的一条途径.增高的CD8＋细胞亚群比例和CD4＋/CD8＋失调可能影响机体清除戊型肝炎病毒的能力,导致感染的持续.

Consequence of acute hepatitis E and change of immune state

AIM：To explore the natural consequence of acute hepatitis E and chang of immune state.METHODS：The serum levels of IFN-γ,IL-4 and IL-12 were measured by using enzymelinked immumo sorbent assay,and T lymphocyte subsets of peripheral blood were observed by fluorescence activated cell sorting（FACS）.RESULTS：Compared with the normal people,groups of Anti-HEV IgM seroconversion patients with acute hepatitis E infection had a significant increase of IL-12,IFN-γ,IL-4,Th1/Th2,CD3＋ 1,CD4＋ and CD4＋ /CD8＋（P0.05） in acute stage.Groups of seroconversion patients in recovery stage had a significant decrease of IL-12,IFN-γ,IL-4,Th1/Th2,CD3＋ 1,CD4＋ and CD4＋ /CD8＋（P0.05）.Groups of Anti-HEV IgM no seroconversion,patients had a significant decrease of IL-12,IFN-γ,Th1/Th2,CD3＋ 1,CD4＋ and CD4＋ /CD8＋（P0.05） in recovery stage.There were a significant decrease of Th1/Th2,CD4＋ /CD8＋（P0.05）.But there were a significant increased of IL-4 and CD8＋ compared with normal controls（P0.05）.CONCLUSION：The increased IL-4 levels may also influence convalescence.The regulating the balance of Th1/Th2 may be a new route of preventing persistent viral infection.It is highly important that the CD4＋ T cells and the CD8＋ T cells bear responsibility for viral clearance,but the imbalance of the CD4＋ /CD8＋ probably results in the persistence of HEV infection.