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慢性肝衰竭急性发作患者不同阶段单核细胞免疫功能的改变

Altered immune function of monocytes in different stages of patients with acute on chronic liver failure.

作者信息

Xing T, Li L, Cao H, Huang J

机构信息

Institute of Infectious Diseases, Zhejiang University, Key Laboratory of Infective Disease, Ministry of Public Health, China.

出版信息

Clin Exp Immunol. 2007 Jan;147(1):184-8. doi: 10.1111/j.1365-2249.2006.03259.x.

Abstract

The aim of this study was to investigate the characteristics of the immune function of monocytes in different stages of the patients with acute on chronic liver failure (ACLF). Human leucocyte antigen (HLA)-DR and Toll-like receptor 4 (TLR-4) expression on monocytes in early and late stages of acute on chronic liver failure were detected by flow cytometry. The secretion function of monocytes was measured by cytometric bead array. Compared with healthy controls, the levels of HLA-DR expression on monocytes in patients with chronic hepatitis B, liver cirrhosis and acute on chronic liver failure were gradually decreased, especially in the late stage of acute on chronic liver failure (P < 0.001). TLR-4 expression on monocytes in patients with liver cirrhosis and acute on chronic liver failure were higher than the healthy controls. The concentrations of interleukin (IL)-1beta, tumour necrosis factor (TNF)-alpha and IL-12p70 in early-stage ACLF were significantly higher compared with healthy controls and lower in late-stage ACLF (P < 0.01, 0.05). However, a significantly lower amount of IL-10 was found on monocytes in early-stage ACLF than that of late-stage ACLF and healthy controls (P < 0.01). Monocyte HLA-DR expression in patients who died was significantly lower compared with patients who survived in the early and late stages of ACLF (P < 0.01). The dynamic detection of HLA-DR expression or cytokines secreted from monocytes could contribute to the estimation of the status of the immune function of patients with acute on chronic liver failure.

摘要

本研究旨在探讨慢加急性肝衰竭(ACLF)患者不同阶段单核细胞免疫功能的特点。采用流式细胞术检测慢加急性肝衰竭早期和晚期患者单核细胞上人白细胞抗原(HLA)-DR及Toll样受体4(TLR-4)的表达。通过细胞计数微球阵列检测单核细胞的分泌功能。与健康对照相比,慢性乙型肝炎、肝硬化及慢加急性肝衰竭患者单核细胞上HLA-DR表达水平逐渐降低,尤其是慢加急性肝衰竭晚期(P<0.001)。肝硬化及慢加急性肝衰竭患者单核细胞上TLR-4表达高于健康对照。慢加急性肝衰竭早期白细胞介素(IL)-1β、肿瘤坏死因子(TNF)-α及IL-12p70浓度显著高于健康对照,而在慢加急性肝衰竭晚期则较低(P<0.01, 0.05)。然而,慢加急性肝衰竭早期单核细胞上IL-10的含量显著低于慢加急性肝衰竭晚期及健康对照(P<0.01)。ACLF早期和晚期死亡患者的单核细胞HLA-DR表达显著低于存活患者(P<0.01)。动态检测单核细胞HLA-DR表达或其分泌的细胞因子有助于评估慢加急性肝衰竭患者的免疫功能状态。

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