慢性乙型肝炎患者抗病毒治疗前后外周血CD4+CD25+调节性T细胞的变化 FREE

目的研究慢性乙型肝炎（乙肝)患者经聚乙二醇干扰素和阿德福韦抗病毒治疗前后外周血CD4+CD25+调节性T细胞（Treg）的变化情况。方法慢性乙肝患者35例，其中聚乙二醇干扰素α 2a(40 KD)治疗（干扰素组）18例，阿德福韦酯治疗（阿德福韦组）17例；另收集肝炎病毒标志物阴性，肝功能正常的健康志愿者12例作对照。采集两治疗组治疗前及治疗12、24、48周时的外周血单个核细胞(PBMC)，以流式细胞技术检测CD4＋CD25＋Treg细胞/PBMCs的百分比，并分析其与血清丙氨酸转氨酶（ALT）、乙肝病毒（HBV）DNA的相关性。结果Treg/PBMCs的百分比，干扰素组和阿德福韦组在治疗前分别为（3.72±1.15）%和（3.63±1.02）%，与正常对照组（2.47±0.90）%相比，差异均有显著性（t分别为2.51、2.48,均P<0.05）。干扰素组经治疗后，CD4＋CD25＋Treg细胞的比例逐渐下降，治疗12、24、48周时的比率分别为（2.87±0.76）%、（2.75±0.72）%和（2.51±0.69）%，与治疗前相比，差异均有显著性（t分别为2.41、2.58、2.95，P分别<0.05、<0.05、<0.01）。阿德福韦组经治疗后，CD4＋CD25＋Treg细胞的比例与治疗前相比，差异无显著性（P＞0.05）。CD4＋CD25＋Treg细胞与ALT的变化呈正相关(r=0.52，P<0.01)，而与HBV DNA无明显的相关性(r=0.25，P>0.05)。结论慢性乙肝患者外周血CD4＋CD25＋Treg细胞升高，聚乙二醇干扰素抗病毒治疗能改善患者的免疫功能状态，降低CD4＋CD25＋Treg细胞比例；而阿德福韦抗病毒治疗对CD4＋CD25＋Treg细胞无影响。

Characteristics of circulating CD4+CD25+ regulatory T cells in chronic hepatitis B patients accepting antiviral therapy FREE

Objective To investigate the characteristics of circulating CD4 ＋ CD25 ＋ regulatory T cells （Treg） in chronic hepatitis B （CHB） patients accepting peginterferon alfa-2a and adefovir therapy. Methods Peripheral blood mononuelear cells （PBMC） of 35 patients with CHB were collected at baseline and week 12, 24 and 48 treatment. Eighteen patients were treated with peginterferon alfa-2a （40 KD） （PEGASYS） and 17 patients were treated with adefovir dipivoxil （ADV）. Twelve healthy volunteers with normal liver function and negative hepatitis virus markers were as controls. The proportion of CD4 ＋ CD25 ＋ Treg/PBMC were analyzed using flow eytometry. The correlation between Treg and serum alanine transaminase（ALT） or HBV DNA was also analyzed. Results The proportion of Treg/PBMC in PEGASYS（-treatment group and ADV-treatment group before treatment were （3.72 ±1.15） and （3.63 ±1.02） % respectively, which were significantly higher than that（2. 47 ±0. 90） % in healthy controls （t = 2. 51, 2. 48; both P〈0. 05）. In PEGASYS group, the proportion of CD4 ＋ CD25 ＋ Treg at week 12, 24 and 48 treatment were （2.87 ±0. 76） %, （2. 75 ±0. 72） % and （2. 51 ± 0. 69） % respectively, which significantly decreased than that of baseline （t = 2. 41,2. 58,2.95; P〈0. 05, 〈0. 05, 〈0. 01）. No significant changes in CD4 ＋ CD25 ＋ Treg were found in ADV-treatment group before and after treatment（P〉0. 05）. A strong correlation was observed between the change in ALT level and the proportion of CD4 ＋ CD25 ＋ Treg （r = 0. 52, P〈0. 01）. No correlation was found between the change in HBV DNA and CD4 ＋ CD25 ＋ Treg（r = 0. 25, P〉0. 05）. Conclusion The level of peripheral blood CD4 ＋ CD25 ＋ Treg in CHB patients is higher than that in healthy controls. PEGASYS antiviral treatment can decrease the proportion of CD4 ＋ CD25 ＋ Treg, while ADV antiviral treatment has no influence on CD4 ＋ CD25 ＋ Treg.