Tian Ying, Li Tai-Sheng
Department of Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
Zhonghua Nei Ke Za Zhi. 2007 Dec;46(12):1014-7.
To investigate the differences of peripheral blood T-lymphocyte subsets and the frequencies of HBV-specific CD4 T cells in patients with symptomatic chronic hepatitis B, asymptomatic HBV carriers and patients who had recovered from subclinical HBV infection, to analyze the relationship between different clinical outcomes after HBV infection and the host's cellular immunity and to give a new clue to the treatment of chronic hepatitis B.
Flow cytometry was used to detect the peripheral blood T-lymphocyte subsets in 30 patients with symptomatic chronic hepatitis B, 22 asymptomatic HBV carriers, 9 patients who had recovered from subclinical HBV infection and 11 healthy blood donors. The frequencies of HBV-specific CD4+ T cells in relation to recombinant HBV core antigen were tested with IFNgamma enzyme-linked immunospot assays (ELISpot).
Compared with patients who had recovered from subclinical HBV infection and normal controls, the count of CD4+ T cells decreased in patients with symptomatic chronic hepatitis B. The frequencies of HBV-specific CD4+ T cells were (156 +/- 105), (56 +/- 68) and (229 +/- 114) SFC/10(6)PBMC (SFC: spot-forming cells; PBMC: peripheral blood mononuclear cells) respectively in patients with symptomatic chronic hepatitis B, asymptomatic HBV carriers and patients who had recovered from subclinical HBV infection. The frequencies of HBV-specific CD4+ T cells in patients with symptomatic chronic hepatitis B were markedly higher than those in asymptomatic HBV carriers (P < 0.01), but lower than that in patients who had recovered from subclinical HBV infection (P < 0.05).
There was significant difference in the frequencies of HBV-specific T cells in patients with symptomatic chronic hepatitis B, asymptomatic HBV carriers and patients who had recovered from subclinical HBV infection and these might be one of the primary reasons for the different clinical outcomes after HBV infection.
探讨症状性慢性乙型肝炎患者、无症状HBV携带者及亚临床HBV感染康复者外周血T淋巴细胞亚群及HBV特异性CD4 T细胞频率的差异，分析HBV感染后不同临床结局与宿主细胞免疫的关系，为慢性乙型肝炎的治疗提供新线索。
采用流式细胞术检测30例症状性慢性乙型肝炎患者、22例无症状HBV携带者、9例亚临床HBV感染康复者及11名健康献血者外周血T淋巴细胞亚群。采用IFNγ酶联免疫斑点试验（ELISpot）检测与重组HBV核心抗原相关的HBV特异性CD4+ T细胞频率。
与亚临床HBV感染康复者及正常对照相比，症状性慢性乙型肝炎患者CD4+ T细胞计数降低。症状性慢性乙型肝炎患者、无症状HBV携带者及亚临床HBV感染康复者的HBV特异性CD4+ T细胞频率分别为（156±105）、（56±68）和（229±114）斑点形成细胞/10(6)外周血单个核细胞（SFC：斑点形成细胞；PBMC：外周血单个核细胞）。症状性慢性乙型肝炎患者的HBV特异性CD4+ T细胞频率显著高于无症状HBV携带者（P<0.01），但低于亚临床HBV感染康复者（P<0.05）。
症状性慢性乙型肝炎患者、无症状HBV携带者及亚临床HBV感染康复者的HBV特异性T细胞频率存在显著差异，这可能是HBV感染后不同临床结局的主要原因之一。
