摘要
目的:观察慢性HBV感染(CHB)免疫清除期PD-1的表达状态以及干扰素抗病毒治疗期间T细胞PD-1的表达,明确免疫清除期CHB患者PD-1表达的临床意义.方法:伴有长期ALT反复升高的CHB患者20例被纳入本研究,所有病例均接受为期6mo的Peg干扰素(1.5μg/kg)抗病毒治疗,每周1次.应用流式细胞术对所有患者抗病毒治疗不同时间点(0、12、24wk)的外周血总CD8+T细胞和CD4+T细胞PD-1表达百分比和表达强度进行检测.结果:免疫清除期CHB患者外周血总CD8+T细胞和CD4+T细胞PD-1阳性率和PD-1表达荧光强度均明显高于健康对照组(P<0.05);PEG干扰素治疗早期CD8+T细胞PD-1阳性率呈现明显下降,且CD8+T细胞PD-1表达阳性率同ALT水平和病毒水平均呈现明显正相关(R2=0.22,0.357,P=0.001,0.002).结论:CHB患者外周血T细胞PD-1呈高表达;干扰素治疗诱导的病毒水平下降可导致CD8+T细胞PD-1表达明显下降.
AIM：To investigate the expression of PD-1 on the surface of T cells in CHB patients in immune clearance phase and the dynamic changes in PD-1 expression on the surface of T cells in CHB patients during IFN-alpha 2b therapy,and analyze the prognostic significance of PD-1 expression in CHB infection patients after antiviral therapy.METHODS：Twenty CHB patients with longterm elevated serum alanine aminotransferase （ALT） level were enrolled.All the patients underwent IFN-alpha 2b therapy （1.5 μg/kg,once a week） for 6 months. PD-1 expression on the surface of total peripheral CD8^＋ and CD4^＋ T cells was evaluated using flow cytometry at different time points during the therapy.RESULTS： The positive rates and mean fluo- rescence intensity （MFI） of PD-1 expression on CD4^＋ and CD8^＋ T cells were significantly higher in CHB patients in immune clearance phase than in normal controls （all P 〈 0.05）. During IFN-al- pha 2b therapy, the positive rate of PD-1 expression on CD8^＋ T cells declined significantly over time. In CHB patients undergoing IFN-alpha 2b therapy, the positive rate of PD-1 expression on CD8^＋ T cells was positively correlated with both serum ALT level and HBV DNA level. CONCLUSION： PD-1 is upregulated on total peripheral T cells in CHB patients in immune clearance phase. Interferon treatment-induced suppression of HBV replication results in a significant reduction in PD-1 expression on the surface of CD8^＋ T cells.
出处
《世界华人消化杂志》
CAS
北大核心
2009年第28期2899-2902,共4页
World Chinese Journal of Digestology
作者简介
梁雪松，医学博士，主要从事病毒性肝炎免疫发病机制研究．
通讯作者：万谟彬，教授，200433，上海市，上海长海医院感染科mobinwan@yahoo．com电话：021—81873504
