摘要
目的探讨乙型肝炎病毒（HBV）侵犯新生儿外周血单个核细胞（PBMC）后，对新生儿免疫功能的影响，了解其免疫失败发生的机理。方法聚合酶链反应法（PCR）检测67对乙型肝炎表面抗原（HBsAg）、乙型肝炎e抗原（HBeAg）阳性孕妇及其新生儿血清和PBMC的HBV DNA。根据新生儿PBMC中HBV DNA分成阴性和阳性组，将新生儿的PBMC分别在植物血凝素（PHA）和纯化HBsAg刺激下进行体外细胞培养，检测培养上清液中干扰素-γ（IFN-γ）、白介素4（IL-4）的分泌含量。结果（1）35例母亲PBMC HBV DNA阳性者其新生儿15例为阳性，母亲与患儿PBMC HBV DNA阳性，差异有显著统计学意义（P〈0．01）。（2）新生儿PBMC内HBV DNA阳性组与阴性组比较，纯化HBsAg刺激时，阳性组IFN-γ的分泌量较阴性组低（P〈0．01），IL4含量显示PBMC HBV DNA阳性组高于阴性组（P〈0．05），PHA刺激时，两组IFN-γ、IL-4含量差异无统计学意义（P〉0．05）。结论PBMC内的HBV DNA可能是HBV母婴垂直传播的一条重要途径；宫内新生儿PBMC感染HBV，IFN-γ特异性反应低下，而IL-4特异性反应增强，细胞调节失衡，可能是新生儿免疫失败和易于免疫耐受的一个重要原因。
Objective To observe the effect of intrauterine hepatitis B virus （HBV） infection on peripheral blood mononuelear cells function of secreting interferon-γ, and interleukin-4. Methods Pregnant women were systematically screened for HBsAg and HBeAg when attending the antenatal clinic at the Qinhuangdao Maternal and Child Health Hospital. Totally 67 pairs of mothers and infants were enrolled into this study after obtaining the women＇s consent. Venous blood samples were collected from the infants within 6 hours after birth and before HBIG injection and HBVae immunization. Blood sample was taken from the mother at or after the time when the infant was born. HBV DNA in plasma and PBMC from mothers and their newborns were examined using polymerase chain reaction （ PCR）. According to HBV DNA in PBMC of newborns, they were divided into two groups. The PBMCs isolated from newborn were cultured with purified HBsAg or phytohemagglutinin （PHA）. The supernatant interleukin-4 and interferon-γ, level was measured by using enzyme linked immunosorbent assay （ELISA）. Results In 19 newborns PBMC was positive for HBV DNA. Maternal PBMC HBV DNA positivity was associated with high rate of intrauterine HBV infection in the infants （Х^2 = 7.58, P 〈 0.01 ）. Compared with the infants whose PBMC HBV DNA was negative, the infants with PBMC positive for HBV DNA expressed a lower level interferon-γ, secretion after purified HBsAg stimulation （ t = 4. 71, P 〈 0. 01 ）, however, no significant difference was seen after PHA stimulation （t = 1.21, P 〉0.05 ）. The supernatant IL-4 level detected after stimulation with purified HBsAg was higher in the newborns whose PBMC HBV DNA was positive as compared with those negative for PBMC HBV DNA （ t = - 8.51 ,P 〈 0.05 ）. The level of IL-4 did not show any significant difference after stimulation with PHA between the PBMC HBV DNA negative and positive groups （ t = - 2.40, P 〉 0. 05 ）. Conclusion Infection with HBV of maternal PBMC is responsible for perinatal newborn＇s PBMC HBV infection and it may be an important route of HBV vertical transmission. Infants whose mothers were positive for HBsAg, HBeAg and HBV DNA were at extraordinarily high risk for hepatitis B virus infection. PBMC infected with HBV could influence the status of humoral and cellular immunity resulting in persistent HBV infection and recurrent mother to infant transmission of HBV. Low responses of interferon-gamma and high interleukin-4 transcription upon specific stimulation exist in infants whose PBMC were positive for HBV DNA in uterus may contribute to immune tolerance to HBV.
出处
《中华儿科杂志》
CAS
CSCD
北大核心
2008年第7期531-534,共4页
Chinese Journal of Pediatrics
关键词
肝炎病毒
乙型
疾病传播
垂直
白细胞
单核
聚合酶链反应
干扰素Ⅱ型
受体
白细胞介素4
Hepatitis B virus
Disease transmission, vertical
Leukocytes, mononuclear
Polymerase chain reaction
Interferon type Ⅱ
Receptors, interleukin-4
