慢性丙型肝炎患者肝免疫标志物和病毒基因型研究

目的研究慢性丙型肝炎患者肝免疫标志物和病毒基因型的关系。方法取28例HFE基因型患者的肝活检标本进行切片染色，并通过形态测定法分析CD8，主要组织相容性复合体-Ⅰ类（major histocompatibility complex class Ⅰ，MHC-Ⅰ），β2微球蛋白（β2 microglobulin，β2-mG），HFE和CD68。其中18例患者的治疗应答性资料有效。结果CD8^＋常聚集于肝汇管区和窦状隙，CD8^＋与MHC-Ⅰ阳性内样细胞相互作用。MHC-Ⅰ和β2-mG主要表达于内皮细胞和枯否细胞，而大多数HFE表达于圆形和树突状CD68^＋细胞。基因型为3a的丙型肝炎患者肝MHC-Ⅰ和HFE强表达，且对干扰素治疗持续应答率较高。结论慢性丙型肝炎患者MHC-Ⅰ的肝脏表达可能与病毒基因型相关。HCV 3a基因型上调MHC-Ⅰ和HFE的表达。

Correlation between hepatic immunological markers and virus genotype in patients with chronic hepatitis C

OBJECTIVE: To investigate the hepatic expression of immunological markers relevant to a cytotoxic response in relation to viral genotype. METHODS: The frozen liver biopsies were obtained from 28 HF genotyped patients and made the sections stained. The morphometry was used to analyze the major histocompatibility complex class I (MHC-I), CD8, beta(2)-microglobulin (beta(2) -mG), HFE and CD68 in the stained sections. Biopsy data of response to therapy with interferon were available in 18 cases. RESULTS: CD8+ was usually clustered together and localized in portal tracts and sinusoids, and seen to interact with MHC I positive lining cells. MHC-I and beta(2) -mG were expressed mainly in endothelial and Kupffer cells. HFE was expressed in most round and dendritic CD68+ cells. Patients with virus genotype 3a had higher hepatic MHC-I and HFE expression, and a better sustained response to interferon (IFN) therapy than patients without. CONCLUSION: The MHC-I expression in the liver of patient with chronic hepatitis C virus infection seems to relate to viral-genotype. The hepatic MHC-I and HFE expression are higher in patients with virus genotype 3a than that in patients with non-3a genotype.