Li Ming-Hui, Zhang Dan, Zhang Lu, Qu Xiao-Jing, Lu Yao, Shen Ge, Wu Shu-Ling, Chang Min, Liu Ru-Yu, Hu Lei-Ping, Hao Hong-Xiao, Hua Wen-Hao, Song Shu-Jing, Wan Gang, Liu Shun-Ai, Xie Yao
Liver Diseases Center, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China.
Clinical Laboratory, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China.
Chin Med J (Engl). 2017 Aug 5;130(15):1810-1815. doi: 10.4103/0366-6999.211541.
Hepatitis B is an immune response-mediated disease. The aim of this study was to explore the differences of ratios of T-helper (Th) 2 cells to Th1 cells and cytokine levels in acute hepatitis B (AHB) patients and chronic hepatitis B virus (HBV)-infected patients in immune-tolerance and immune-active phases.
Thirty chronic HBV-infected patients in the immune-tolerant phase (IT group) and 50 chronic hepatitis B patients in the immune-active (clearance) phase (IC group), 32 AHB patients (AHB group), and 13 healthy individuals (HI group) were enrolled in the study. Th cell proportions in peripheral blood, cytokine levels in plasma, and serum levels of HBV DNA, hepatitis B surface antigen, and hepatitis B e antigen were detected.
The Th1 cell percentage and Th2/Th1 ratio in the HBV infection group (including IT, IC, and AHB groups) were significantly different from those in HI group (24.10% ± 8.66% and 1.72 ± 0.61 vs. 15.16% ± 4.34% and 2.40 ± 0.74, respectively; all P < 0.001). However, there were no differences in the Th1 cell percentages and Th2/Th1 ratios among the IT, IC, and AHB groups. In HBV infection group, the median levels of Flt3 ligand (Flt3L), interferon (IFN)-γ, and interleukin (IL)-17A were significantly lower than those in HI group (29.26 pg/ml, 33.72 pg/ml, and 12.27 pg/ml vs. 108.54 pg/ml, 66.48 pg/ml, and 35.96 pg/ml, respectively; all P < 0.05). IFN-α2, IL-10, and transforming growth factor (TGF)-β2 median levels in hepatitis group (including patients in AHB and IC groups) were significantly higher than those in IT group (40.14 pg/ml, 13.58 pg/ml, and 557.41 pg/ml vs. 16.74 pg/ml, 6.80 pg/ml, and 419.01 pg/ml, respectively; all P < 0.05), while patients in hepatitis group had significant lower Flt3L level than IT patients (30.77 vs. 59.96 pg/ml, P = 0.021). Compared with IC group, patients in AHB group had significant higher median levels of IL-10, TGF-β1, and TGF-β2 (22.77 pg/ml, 10,447.00 pg/ml, and 782.28 pg/ml vs. 8.66 pg/ml, 3755.50 pg/ml, and 482.87 pg/ml, respectively; all P < 0.05).
Compared with chronic HBV-infected patients in immune-tolerance phase, chronic HBV-infected patients in immune-active phase and AHB patients had similar Th2/Th1 ratios, significantly higher levels of IFN-α2, IL-10, and TGF-β. AHB patients had significantly higher IL-10 and TGF-β levels than chronic HBV-infected patients in immune-active phase.
乙型肝炎是一种免疫反应介导的疾病。本研究旨在探讨急性乙型肝炎（AHB）患者以及处于免疫耐受期和免疫激活期的慢性乙型肝炎病毒（HBV）感染患者中辅助性T（Th）2细胞与Th1细胞比例及细胞因子水平的差异。
本研究纳入了30例处于免疫耐受期的慢性HBV感染患者（IT组）、50例处于免疫激活（清除）期的慢性乙型肝炎患者（IC组）、32例AHB患者（AHB组）以及13名健康个体（HI组）。检测外周血中Th细胞比例、血浆中细胞因子水平以及血清中HBV DNA、乙型肝炎表面抗原和乙型肝炎e抗原水平。
HBV感染组（包括IT组、IC组和AHB组）的Th1细胞百分比和Th2/Th1比值与HI组显著不同（分别为24.10%±8.66%和1.72±0.61，对比15.16%±4.34%和2.40±0.74；所有P<0.001）。然而，IT组、IC组和AHB组之间的Th1细胞百分比和Th2/Th1比值并无差异。在HBV感染组中，Flt3配体（Flt3L）、干扰素（IFN）-γ和白细胞介素（IL）-17A的中位数水平显著低于HI组（分别为29.26 pg/ml、33.72 pg/ml和12.27 pg/ml，对比108.多pg/ml、66.48 pg/ml和35.96 pg/ml；所有P<0.05）。肝炎组（包括AHB组和IC组患者）中IFN-α2、IL-10和转化生长因子（TGF）-β2的中位数水平显著高于IT组（分别为40.14 pg/ml、13.58 pg/ml和557.41 pg/ml，对比16.74 pg/ml、6.80 pg/ml和419.01 pg/ml；所有P<0.05），而肝炎组患者的Flt3L水平显著低于IT组患者（30.77对比59.96 pg/ml，P = 0.021）。与IC组相比，AHB组患者的IL-10、TGF-β1和TGF-β2中位数水平显著更高（分别为22.77 pg/ml、10447.00 pg/ml和782.28 pg/ml，对比8.66 pg/ml、3755.50 pg/ml和482.87 pg/ml；所有P<0.05）。
与处于免疫耐受期的慢性HBV感染患者相比，处于免疫激活期的慢性HBV感染患者和AHB患者具有相似的Th2/Th1比值，IFN-α2、IL-10和TGF-β水平显著更高。AHB患者的IL-10和TGF-β水平显著高于处于免疫激活期的慢性HBV感染患者。
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