National and Local Joint Engineering Research Center of Biodiagnosis and Biotherapy, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Shaanxi Provincial Clinical Research Center for Hepatic and Splenic Diseases, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Viral Immunol. 2020 Mar;33(2):112-121. doi: 10.1089/vim.2019.0146. Epub 2020 Feb 26.
The difference of splenic pathologic alterations and immune function changes in portal hypertension (PHT) with different etiology is unclear. We aimed to investigate the differences between the hypersplenic patients with hepatitis B virus (HBV)-related PHT and Budd-Chiari syndrome (B-CS). A total of 93 patients with hypersplenism due to Chinese primary B-CS (B-CS group), 105 patients with hypersplenism due to HBV-related cirrhosis (HBV/PHT group), and 31 healthy people (control group) were included in this study retrospectively. The peripheral bloods and paraffin sections of the spleen from part of patients were analyzed by flow cytometry and immunohistochemistry. Hypersplenism and PHT were more serious in HBV/PHT group than in B-CS group. In the peripheral blood, the percentages of regulatory T cell (15.1% vs. 8.1% vs. 2.2%, = 0.0021) and myeloid-derived suppressive cells (2.8% vs. 0.8% vs. 0.9%, = 0.009) were higher, but CD4+ T and CD8+ T cells were lower in HBV/PHT group compared with B-CS and control groups. In spleen, the percentages of CD4+ T and CD8+ T cells were lower, but CD68+ macrophages were higher in HBV/PHT group than in B-CS group. Moreover, CD86, inducible nitric oxide synthase, Toll-like receptor 4, and tumor necrosis factor- expression in the spleen, as well as the plasma lipopolysaccharide (LPS) level (677.7 vs. 311.1 vs. 222.1 ng/mL, = 0.0022), were significantly higher in HBV/PHT group than in B-CS and control groups. The HBV/PHT group showed more severe immunosuppression and immune dysfunction and more substantial hypersplenism and splenic phagocytosis than B-CS group.
乙型肝炎病毒（HBV）相关门静脉高压（PHT）与不同病因导致的脾病理改变和免疫功能变化的差异尚不清楚。本研究旨在探讨乙型肝炎病毒（HBV）相关肝硬化（HBV/PHT）和布加综合征（B-CS）导致的脾亢患者之间的差异。本研究回顾性纳入 93 例原发性 B-CS 导致的脾亢患者（B-CS 组）、105 例 HBV 相关肝硬化导致的脾亢患者（HBV/PHT 组）和 31 名健康人（对照组）。通过流式细胞术和免疫组化分析部分患者的外周血和脾脏石蜡切片。HBV/PHT 组的脾亢和 PHT 比 B-CS 组更严重。在外周血中，调节性 T 细胞（15.1%比 8.1%比 2.2%， = 0.0021）和髓源性抑制细胞（2.8%比 0.8%比 0.9%， = 0.009）的比例较高，而 CD4+T 和 CD8+T 细胞则低于 HBV/PHT 组和对照组。在脾脏中，HBV/PHT 组的 CD4+T 和 CD8+T 细胞比例较低，而 CD68+巨噬细胞比例较高。此外，HBV/PHT 组的脾脏中 CD86、诱导型一氧化氮合酶、Toll 样受体 4 和肿瘤坏死因子-α的表达以及血浆脂多糖（LPS）水平（677.7 比 311.1 比 222.1 ng/mL， = 0.0022）均明显高于 B-CS 组和对照组。HBV/PHT 组表现出更严重的免疫抑制和免疫功能障碍，以及更严重的脾亢和脾脏吞噬作用。
