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免疫细胞亚群评估作为乙型肝炎感染结局和治疗反应性的预测工具

Immune Cell Subsets Evaluation as a Predictive Tool for Hepatitis B Infection Outcome and Treatment Responsiveness.

作者信息

Kandilarova Snezhina M, Georgieva Atanaska I, Mihaylova Anastasiya P, Baleva Marta P, Atanasova Valentina K, Petrova Diana V, Popov Georgi T, Naumova Elissaveta J

机构信息

Department of Clinical Immunology and Stem Cell Bank, Alexandrovska University Hospital, Medical University of Sofia, 1 G. Sofiisky St. 1431 Sofia.

Department of Clinical Immunology and Stem Cell Bank, Alexandrovska University Hospital, Medical University of Sofia, Sofia.

出版信息

Folia Med (Plovdiv). 2017 Mar 1;59(1):53-62. doi: 10.1515/folmed-2017-0008.

Abstract

BACKGROUND

The patient's immune response is one of the major factors influencing HBV eradication or chronification, and it is thought to be responsible for the treatment success.

AIM

Our study aimed to investigate whether cellular defense mechanisms are associated with the course of HBV infection (spontaneous recovery [SR] or chronification [CHB]) and with the therapeutic approach.

PATIENTS AND METHODS

A total of 139 patients (118 with CHB, 21 SR) and 29 healthy individuals (HI) were immunophenotyped by flowcytometry. Fifty-six patients were treatment-naïve, 20 were treated with interferons and 42 with nucleoside/ nucleotide analogues.

RESULTS

Deficiency of T lymphocytes, helper-inducer (CD3+CD4+), suppressorcytotoxic (CD8+CD3+) and cytotoxic (CD8+CD11b-, CD8+CD28+) subsets, activated T cells (CD3+HLA-DR+, CD8+CD38+) and increased CD57+CD8- cells, elevated percentages of B lymphocytes and NKT cells were observed in CHB patients compared with HI. In SR patients, elevated CD8+CD11b+, NKT and activated T cells were found in comparison with controls. The higher values of T cells and their subsets in SR patients than in CHB patients reflect a recovery of cellular immunity in resolved HBV infection individuals. In both groups of treated patients, reduced T lymphocytes, CD3+CD4+ and CD8+CD38+ subsets were found in comparison with HI. Higher proportions of cytotoxic subsets were observed in treated patients compared with treatment-naïve CHB patients, more pronounced in the group with interferon therapy.

CONCLUSION

Our data demonstrate that cellular immune profiles may be of prognostic value in predicting the clinical course of HBV infection, and the determination of the therapeutic response.

摘要

背景

患者的免疫反应是影响乙肝病毒清除或慢性化的主要因素之一,被认为与治疗成功与否有关。

目的

我们的研究旨在调查细胞防御机制是否与乙肝病毒感染病程(自发恢复[SR]或慢性化[CHB])以及治疗方法相关。

患者与方法

通过流式细胞术对139例患者(118例慢性乙肝患者,21例自发恢复者)和29名健康个体(HI)进行免疫表型分析。56例患者未接受过治疗,20例接受干扰素治疗,42例接受核苷/核苷酸类似物治疗。

结果

与健康个体相比,慢性乙肝患者中观察到T淋巴细胞、辅助诱导型(CD3 + CD4 +)、抑制细胞毒性型(CD8 + CD3 +)和细胞毒性型(CD8 + CD11b -、CD8 + CD28 +)亚群缺乏,活化T细胞(CD3 + HLA - DR +、CD8 + CD38 +)增加,CD57 + CD8 -细胞增多,B淋巴细胞和NKT细胞百分比升高。与对照组相比,自发恢复患者中发现CD8 + CD11b +、NKT和活化T细胞升高。自发恢复患者中T细胞及其亚群的值高于慢性乙肝患者,这反映了乙肝病毒感染已缓解个体的细胞免疫恢复。在两组接受治疗的患者中,与健康个体相比,T淋巴细胞、CD3 + CD4 +和CD8 + CD38 +亚群减少。与未接受治疗的慢性乙肝患者相比,接受治疗的患者中细胞毒性亚群比例更高,在干扰素治疗组中更明显。

结论

我们的数据表明,细胞免疫谱在预测乙肝病毒感染的临床病程和治疗反应方面可能具有预后价值。

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