慢性丙型肝炎肝内及周围血淋巴细胞亚群表型分析

目的：机体细胞免疫反应在慢性丙型肝炎中可能起着重要的作用，但是否像乙型肝炎病毒感染那样，丙型病毒（ＨＣＶ）也无肝细胞毒性而是通过机体免疫反应造成肝组织细胞损伤的呢？目前还不完全清楚。方法：为了探索肝内淋巴细胞免疫反应在慢性ＨＣＶ感染中的作用，我们对３６例慢性ＨＣＶ感染病人及６例正常对照应用三色荧光单抗标记流式细胞分析法进行了肝内及周围血淋巴细胞亚群表型测定，并同时应用ＰＣＲ技术进行了血清中ＨＣＶ复制率测定及肝脏组织学检查。结果：周围血中各种淋巴细胞亚群表型在慢性ＨＣＶ感染病人与对照组相似，难以反应ＨＣＶ感染及肝脏损伤情况，而慢性ＨＣＶ感染病人肝内ＣＤ４＋淋巴细胞显著高于对照组，致使肝内ＣＤ４＋／ＣＤ８＋淋巴细胞比率也显著高于对照组（０．５５±０．２１ｖｓ０．２３±０．１２，Ｐ＝０．０４６）。结论：提示ＣＤ４＋Ｔｈ淋巴细胞正性调节ＣＤ８＋Ｔｃ淋巴细胞可能是引起肝细胞损伤的主要原因

Analysis of intrahepatic and peripheral blood lymphocyte subpopulations in chronic hepatitis C by three colour flow cytometry

Aim:The host immune response have been suggested to play an important role in liver injury occurring in patients with chronic hepatitis C.It remains unclear weather HCV is like HBV by itself not cytopathic and the liver damage induced by HVC is really mediated by the immune system.Methads:In order to explore the role of cellular immune response in liver injury with chronic hepatitis C,three colour fluorescence activated cytometric analysis was performed to phenotype intrahepatic and peripheral blood lymphocytes (IHL,PBL) for 36 patients with chronic hepatitis C before interferon therapy and 6 control subjects.The technique of PCR was also used to quantitate the levels of viremia and histological hepatitis activity scores were determined by the same histologist.Results:It was shown that the proportions of PBL in patients and control subjects were similar,So PBL is difficult to reflect HCV infction and liver injury.However,the proportion of CD4 IHL was significantly increased in patients with chronic hepatitis C,resulting in IHL CD4 /CB8 ratio also significantly higher than in control subjects (0.55 0.21 vs 0.23 0.12,p=0.046).Conclusion:This suggests that in situ helper/inducer CD4 T lymphocytes may positively regulate the cytotoxic T cell activity in patients with chronic hepatitis C to lead to damage of liver.