He Li-Jie, Zhang He-Ping, Li Hong-Juan, Wang Jing, Chang Dan-Dan
Clin Lab. 2016 Oct 1;62(10):1933-1939. doi: 10.7754/Clin.Lab.2016.160210.
To study the effect of 25-hydroxyl vitamin D3 on peripheral blood T lymphocyte immune function and antiviral effects in chronic hepatitis B patients.
The clinical data for 70 patients with chronic hepatitis B were analyzed. Serum 25-hydroxyl vitamin D was determined by electrochemical luminescence, and hepatitis B virus serological markers were determined by fluorescence quantitative polymerase chain reaction. Subsets of T lymphocytes were determined by immune fluorescence labeling method. These patients were divided into three groups based on serum 25-hydroxyl vitamin D level. After six months of pegylated interferon treatment, three groups have their number of T lymphocyte, liver functions, and virological indexes examined at the corresponding time.
The years and ratio of gender have no statistical differences in these three groups. The proportion of CD3+, CD4+ T lymphocytes and the ratio of CD4+/CD8+ significantly increased (p < 0.05) as the level of 25-hydroxyl vitamin D increased, but the proportion of CD8+ decreased. Interferon treatment can improve the T cells subgroup, and the high level group of serum 25-hydroxyl vitamin D improved more obviously. The positive ratio of HBeAg, HBsAg and the titer of HBV DNA decreased with the increase of serum vitamin D, and the difference between the high and low level 25-hydroxyl vitamin D groups was significant (p < 0.05). The treatment of interferon can obviously improve the hepatitis B virus serological markers; the high level group of serum 25-hydroxyl vitamin D can obtain better virological response. However, there was no significant difference between the three groups of serological markers of liver function.
Vitamin D may play a part in the immunologic function adjustment and immune tolerance in the natural course of chronic HBV infection, and high levels of vitamin D may be able to achieve sustained virological response. These findings may shed light on the research and treatment of chronic hepatitis B pathogenesis.
研究25-羟基维生素D3对慢性乙型肝炎患者外周血T淋巴细胞免疫功能及抗病毒作用的影响。
分析70例慢性乙型肝炎患者的临床资料。采用电化学发光法测定血清25-羟基维生素D，采用荧光定量聚合酶链反应法测定乙肝病毒血清学标志物。采用免疫荧光标记法测定T淋巴细胞亚群。根据血清25-羟基维生素D水平将这些患者分为三组。聚乙二醇干扰素治疗6个月后，三组在相应时间检测T淋巴细胞数量、肝功能及病毒学指标。
三组患者的年龄和性别比例无统计学差异。随着25-羟基维生素D水平的升高，CD3+、CD4+ T淋巴细胞比例及CD4+/CD8+比值显著升高（p<0.05），但CD8+比例降低。干扰素治疗可改善T细胞亚群，血清25-羟基维生素D高水平组改善更明显。随着血清维生素D水平的升高，HBeAg、HBsAg阳性率及HBV DNA滴度降低，25-羟基维生素D高低水平组间差异有统计学意义（p<0.05）。干扰素治疗可明显改善乙肝病毒血清学标志物；血清25-羟基维生素D高水平组可获得更好的病毒学应答。然而，三组肝功能血清学标志物之间无显著差异。
维生素D可能在慢性HBV感染的自然病程中参与免疫功能调节和免疫耐受，高水平维生素D可能能够实现持续病毒学应答。这些发现可能为慢性乙型肝炎发病机制的研究和治疗提供线索。
