胰岛素抵抗的慢性丙型肝炎患者外周血CD4+CD25+调节性T细胞的数量及其功能

目的 了解胰岛素抵抗的慢性丙型肝炎患者外周血CD4 +CD25+调节性T细胞(Treg)数量和功能的变化.方法 筛选40例HLA-A2+慢性丙型肝炎患者(其中20例合并胰岛素抵抗),流式细胞仪检测患者CD4+CD25+Treg细胞占外周血中CD4+T细胞的频率,液闪计数仪检测对HCV特异性CD8+T细胞增殖的抑制作用,ELISA法检测IFN-y水平.统计学处理采用t检验.结果 胰岛素抵抗的慢性丙型肝炎患者外周血CD4 +CD25+ Treg细胞占CD4+T细胞的(9.5±1.9)％,明显低于慢性丙型肝炎患者的(11.2±2.2)％(t=2.615,P＜0.05).胰岛素抵抗指数(HOMA-IR)≥4患者的CD4+CD25+ Treg细胞比例为(9.0±1.8)％,明显低于HOMA-IR＜4患者的(10.8±2.3)％(t=2.413,P＜0.05).胰岛素抵抗的慢性丙型肝炎患者CD4+CD25+ Treg细胞和去除Treg的外周血单个核细胞(PBMC)共培养上清液中IFN-y为(4 050±580) pg/mL,明显高于慢性丙型肝炎患者的(2 005±330)pg/mL(t=13.705,P＜0.01).HOMA-IR≥4患者IFN-y为(5 682±986)pg/mL,明显高于HOMA-IR＜4患者的(2 819±660) pg/mL(t=7.630,P＜0.01).结论 随着胰岛素抵抗程度加重,慢性丙型肝炎患者外周血CD4+ CD25+ Treg细胞频率减低,对HCV特异性CD8+T细胞增殖的抑制作用减弱.

The study of number and function of peripheral blood CD4 +CD25 + regulatory T cells in patients with chronic hepatitis C and insulin resistance

Objective To study the change of number and function of peripheral blood CD4+ CD25+ regulatory T(Treg) cells in patients with chronic hepatitis C(CHC) and insulin resistance(IR).Methods Forty HLA-A2+ CHC patients(including 20 patients with CHC and IR) were enrolled in this study.The frequency of CD4+CD25+Treg cells in the peripheral blood CD4+ T cells was detected by flow cytometry.The proliferation of HCV CD8+ T lymphocytes was examined by liquid scintillation spectroscopy and the IFN-γ level of cells culture supernatant was detected by ELISA.Results The frequency of CD4+ CD25+Treg cells in the peripheral blood CD4+T cells of patients with CHC and IR was significantly lower than that of patients with CHC [(9.5±1.9)% vs(11.2±2.2)%,t=2.615,P<0.05].The frequency of Treg cells of patients with HOMA-IR≥4 was significantly lower than that of patients with HOMA-IR<4 [(9.0±1.8)% vs(10.8±2.3)%,t=2.413,P<0.05].The amount of co-culture supernatant IFN-γ of patients with CHC and IR was significantly higher than that of patients with CHC [(4 050±580) vs(2 005±330) pg/mL,t=13.705,P<0.01].The amount of IFN-γ of patients with HOMA-IR≥4 was significantly higher than that of patients with HOMA-IR<4 [(5 682±986) vs(2 819±660) pg/mL,t=7.630,P<0.01].Conclusion With the aggravations of IR,the frequency of CD4+ CD25+Treg cells in the peripheral blood and its inhibitory on CD8+T cell proliferation of patients with CHC decrease.