Sprengers Dave, van der Molen Renate G, Kusters Johannes G, De Man Robert A, Niesters Hubert G M, Schalm Solko W, Janssen Harry L A
Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Dr Molewaterplein 40, 3015 GD Rotterdam, The Netherlands.
J Hepatol. 2006 Aug;45(2):182-9. doi: 10.1016/j.jhep.2005.12.022. Epub 2006 Feb 6.
BACKGROUND/AIMS: Characteristics of the intrahepatic virus-specific T-cell response in patients with acute hepatitis B virus (HBV) infection have not been studied due to the risk of complications associated with standard liver biopsies. In this study we aimed to characterize the virus-specific CD8 + T-cell response in the liver of patients with acute HBV infection using fine-needle aspiration-biopsy (FNAB).
In HLA-A2 positive patients with acute HBV infection a FNAB was performed at first presentation, at the time of HBsAg-seroconversion and 3 months after HBsAg-seroconversion. HLA-A2 tetramers were used to identify HBV-specific CD8 + T-cells in FNAB-cytology and peripheral blood (PB).
At first presentation there was a correlation between the frequency of intrahepatic CD8 + T-cells and the degree of liver damage. At all time points there was sequestering of HBV-specific CD8 + T-cells in the liver, and the percentage of intrahepatic HLA-DR expressing HBV-specific CD8 + T-cells was higher than in PB. Three months after HBsAg-seroconversion the frequency of intrahepatic HBV-specific CD8 + T-cells remained high.
HBV-specific CD8 + T-cells are compartmentalized in the liver during acute HBV infection. Their presence in the liver may suggest a role in the resolution of the infection. Intrahepatic HBV-specific CD8 + T cells remain detectable at high frequencies after HBsAg-seroconversion.
背景/目的:由于标准肝活检存在并发症风险,急性乙型肝炎病毒(HBV)感染患者肝内病毒特异性T细胞反应的特征尚未得到研究。在本研究中,我们旨在使用细针穿刺活检(FNAB)来描述急性HBV感染患者肝脏中病毒特异性CD8 + T细胞反应的特征。
对HLA - A2阳性的急性HBV感染患者,在首次就诊时、HBsAg血清学转换时以及HBsAg血清学转换后3个月进行FNAB。使用HLA - A2四聚体来鉴定FNAB细胞学检查和外周血(PB)中的HBV特异性CD8 + T细胞。
首次就诊时,肝内CD8 + T细胞频率与肝损伤程度之间存在相关性。在所有时间点,肝脏中均存在HBV特异性CD8 + T细胞的隔离,且肝内表达HLA - DR的HBV特异性CD8 + T细胞百分比高于外周血。HBsAg血清学转换后3个月,肝内HBV特异性CD8 + T细胞频率仍保持较高水平。
急性HBV感染期间,HBV特异性CD8 + T细胞在肝脏中呈分隔状态。它们在肝脏中的存在可能提示在感染清除中发挥作用。HBsAg血清学转换后,肝内HBV特异性CD8 + T细胞仍可在高频下检测到。