Tsai S L, Chen P J, Lai M Y, Yang P M, Sung J L, Huang J H, Hwang L H, Chang T H, Chen D S
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Republic of China.
J Clin Invest. 1992 Jan;89(1):87-96. doi: 10.1172/JCI115590.
T cell proliferative responses to hepatitis B virus-encoded envelope antigen (S + preS2 + preS1), recombinant core antigen (HBcAg), and natural hepatitis B e antigen (HBeAg) were examined in 22 HBeAg-positive patients with chronic type B hepatitis and 17 healthy hepatitis B surface antigen (HBsAg) carriers. The results showed that HBeAg-positive patients had (a) higher levels of T cell responses to HBcAg/HBeAg than those of healthy HBsAg carriers (P less than 0.001 and P less than 0.01, respectively); (b) a further increase in these T cell responses during acute exacerbations (P less than 0.05 and P less than 0.05, respectively); (c) subsidence in the T cell responses to HBcAg/HBeAg after recovery from acute exacerbations and HBeAg seroconversion, whereas the responses would persist at high levels if the patients did not enter a clinical remission; and (d) low levels of T cell responses to S + preS2 + preS1 either before or after HBeAg seroconversion. The appearance of increasing T cell responses to HBcAg/HBeAg usually occurred in the early phase of acute exacerbations. These findings imply that HBcAg/HBeAg-specific T cells play an important role in the exacerbations of chronic hepatitis B and in HBeAg seroconversion. HBcAg/HBeAg-specific precursor T cell frequencies were serially studied in selected cases by limiting dilution assay. Elevation (two- to fourfold) of HBcAg/HBeAg-specific precursor T cell frequencies contributed to the increase of HBcAg/HBeAg-specific T cell proliferation during acute exacerbations.
在22例HBeAg阳性的慢性乙型肝炎患者和17例健康的乙型肝炎表面抗原（HBsAg）携带者中，检测了T细胞对乙型肝炎病毒编码的包膜抗原（S + preS2 + preS1）、重组核心抗原（HBcAg）和天然乙型肝炎e抗原（HBeAg）的增殖反应。结果显示，HBeAg阳性患者（a）对HBcAg/HBeAg的T细胞反应水平高于健康HBsAg携带者（分别为P < 0.001和P < 0.01）；（b）在急性发作期间这些T细胞反应进一步增加（分别为P < 0.05和P < 0.05）；（c）急性发作恢复和HBeAg血清学转换后，对HBcAg/HBeAg的T细胞反应下降，而如果患者未进入临床缓解期，反应将持续高水平；（d）HBeAg血清学转换前后对S + preS2 + preS1的T细胞反应水平均较低。对HBcAg/HBeAg的T细胞反应增加通常出现在急性发作的早期阶段。这些发现表明，HBcAg/HBeAg特异性T细胞在慢性乙型肝炎的发作和HBeAg血清学转换中起重要作用。通过有限稀释法对选定病例连续研究了HBcAg/HBeAg特异性前体T细胞频率。急性发作期间，HBcAg/HBeAg特异性前体T细胞频率升高（2至4倍）导致HBcAg/HBeAg特异性T细胞增殖增加。
