乙型肝炎病毒感染者不同病毒载量与细胞免疫应答关系

目的探讨乙型肝炎病毒(HBV)感染者体内病毒载量与TH1/TH2细胞应答的关系。方法选取经实时荧光定量PCR检测HBV DNA载量的90例HBV感染者,根据血清HBV DNA载量将其分为3组,每组30例(A组为HBVDNA载量<103copies/ml、B组为HBV DNA量103～105copies/ml、C组为HBV DNA>106copies/ml,同时,各组内根据ALT结果分为ALT正常和异常组),抽取外周血,以特异性刺激因子HBcAg刺激这3组感染者及对照组外周血单个核细胞(PB-MC),以双抗体夹心法检测各组HBV感染者及对照组PBMC在HBcAg刺激后的IL-2和IL-10量。结果对照组PBMC在HBcAg刺激后IL-2显著高于HBV感染组(p<0.01),IL-10则相反(p<0.05);而三组HBV感染者中,IL-2检测值依次为:A组>B组>C组(p<0.01或p<0.05),IL-10则相反(p<0.01或p<0.05);A、B和C组内,ALT异常组和正常组比较,异常组的IL-2显著高于ALT正常组(p<0.01或p<0.05);而ALT异常组的IL-10和正常组比较,无显著差异(p>0.05)。结论高病毒载量的HBV感染者体内可能以TH2细胞应答占主导,而低病毒载量时则可能以TH1细胞应答为主。

RELATIONSHIP BETWEEN HBV DNA LOAD AND RESPONSE OF CELLS IN PATIENTS INFECTED WITH HEPATITIS B VIRUS

Objective To investigate the relationship between HBV DNA load and response of ceils in patients infected with hepatitis B virus. Methods HBV DNA was detected by real - time fluorescence quantitative Polymerase Chain Reaction（PCR） in 90 cases patients infected with hepatitis B virus. These patients were divided to three groups by their HBV DNA loading. （A group：HBV DNA less than 103 copies/ml; B group：HBV DNA 103 - 105 copies/w_l; C group： HBV DNA more than 106 copies/ml）. Collect the peripheral blood mononuclear cells （PBMC） of patients and control group and the PBMC were stimulated with HBcAg. Detect IL -2 and IL - 10 secreted by PBMC by ELISA. Results IL -2 secreted by PBMC of control group is higher than that of patients infected with hepatitis B virus （p 〈 O. O1 ）, and IL - 10 is reverse （p 〈 0. 05 ）. Among three groups patients infected with hepatitis B virus, the IL -2 of A group is higher than B group,and B group is higher than C greup（p 〈0. 01 orp 〈0. 05） ,and IL - 10 is reverse（p 〈0. 01 orp 〈0. 05）. Among A,B,C groups, IL- 2 of ALT abnormal groups is significantly higher than normal groups （p 〈 0. 01 or p 〈 0. 05 ）, and there is not Significant difference in IL - 10 of ALT normal groups. Conclusion For patients with high HBV DNA load, TH2 cells response may dominate,but TH1 cell response may be the main form for patients with low HBV DNA load.