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肝硬化患者部分脾脏栓塞的宿主免疫效应。

Host Immunological Effects of Partial Splenic Embolization in Patients with Liver Cirrhosis.

机构信息

Division of Gastroenterology and Hepatology, Department of Internal Medicine (Omori), School of Medicine, Faculty of Medicine, Toho University, 6-11-1 Omorinishi, Ota-ku, Tokyo 143-8541, Japan.

出版信息

J Immunol Res. 2018 Jul 15;2018:1746391. doi: 10.1155/2018/1746391. eCollection 2018.

DOI:10.1155/2018/1746391
PMID:30116748
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6079527/
Abstract

PURPOSE

Restoration of the balance between T lymphocyte subsets and between Th1/Th2 cytokines together with improvement of antitumor immunity has been reported after hepatosplenectomy in patients with liver cirrhosis (LC) and hepatocellular carcinoma (HCC). However, the detailed effects of partial splenic embolization (PSE) on host immunity are unknown. Accordingly, this study evaluated host immunity in patients with cirrhosis receiving PSE for thrombocytopenia.

METHODS

Twenty-three adult Japanese patients with cirrhosis and thrombocytopenia underwent PSE using straight coils at our hospital between 2010 and 2015. Blood samples were collected before PSE and 4 weeks after PSE.

RESULTS

The platelet counts were significantly higher 4 weeks after PSE compared with before PSE. The white blood cell count (neutrophils, lymphocytes, and monocytes) also increased significantly after PSE. Furthermore, Th1 cells and Th2 cells showed a significant increase at 4 weeks after PSE compared with before PSE, although there was no significant change of Treg cells. Moreover, serum levels of TNF-alpha, soluble TNF receptor I, and soluble Fas were significantly increased after PSE. There was no significant change of the Child-Pugh score.

CONCLUSIONS

In patients with cirrhosis and thrombocytopenia, PSE not only promoted the recovery of leukopenia and thrombocytopenia but also induced activation of host immunity.

摘要

目的

肝切除术可恢复肝硬化（LC）和肝细胞癌（HCC）患者的 T 淋巴细胞亚群和 Th1/Th2 细胞因子之间的平衡，增强抗肿瘤免疫。然而，部分脾栓塞（PSE）对宿主免疫的详细影响尚不清楚。因此，本研究评估了接受 PSE 治疗血小板减少症的肝硬化患者的宿主免疫。

方法

2010 年至 2015 年，我院对 23 例肝硬化伴血小板减少症的成年日本患者进行了 PSE 治疗，采用直圈。在 PSE 前和 PSE 后 4 周采集血样。

结果

PSE 后 4 周血小板计数明显高于 PSE 前。PSE 后白细胞计数（中性粒细胞、淋巴细胞和单核细胞）也明显增加。此外，与 PSE 前相比，PSE 后 4 周 Th1 细胞和 Th2 细胞明显增加，而 Treg 细胞无明显变化。此外，PSE 后血清 TNF-α、可溶性 TNF 受体 I 和可溶性 Fas 水平明显升高。Child-Pugh 评分无明显变化。

结论

在肝硬化伴血小板减少症患者中，PSE 不仅促进白细胞减少和血小板减少的恢复，而且诱导宿主免疫激活。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cc6/6079527/7790bdfc897b/JIR2018-1746391.007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cc6/6079527/79132b9a5c41/JIR2018-1746391.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cc6/6079527/e051a79c3929/JIR2018-1746391.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cc6/6079527/d07b66d5cebe/JIR2018-1746391.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cc6/6079527/fd12585042ca/JIR2018-1746391.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cc6/6079527/735611868f17/JIR2018-1746391.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cc6/6079527/28ceea7ff276/JIR2018-1746391.006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cc6/6079527/7790bdfc897b/JIR2018-1746391.007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cc6/6079527/79132b9a5c41/JIR2018-1746391.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cc6/6079527/e051a79c3929/JIR2018-1746391.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cc6/6079527/d07b66d5cebe/JIR2018-1746391.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cc6/6079527/fd12585042ca/JIR2018-1746391.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cc6/6079527/735611868f17/JIR2018-1746391.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cc6/6079527/28ceea7ff276/JIR2018-1746391.006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cc6/6079527/7790bdfc897b/JIR2018-1746391.007.jpg

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