State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Rd., Hangzhou 310003, China.
Department of Laboratory Medicine, Yancheng Clinical Medical College of Nanjing Medical University, Yancheng 224001, China.
J Immunol Res. 2020 Nov 17;2020:6027361. doi: 10.1155/2020/6027361. eCollection 2020.
The involvement of cellular immunity in the development of hepatitis E virus (HEV) infection is rare. We aimed to study the roles of viral load and Th cell responses in acute hepatitis E (AHE) and HEV-related acute liver failure (HEV-ALF).
We evaluated viral load and Th1/Th2 cytokine levels in 34 patients with HEV infection, including 17 each with AHE or HEV-ALF. Seventeen healthy controls (HCs) were also included who were negative for anti-HEV IgM and IgG.
There was no significant difference in viral load and HEV RNA in the AHE and HEV-ALF groups (both > 0.05). The Th lymphocyte levels (CD3+, CD4+) in the AHE and HEV-ALF groups were significantly higher than those in the HC group (both < 0.05), but there was no significant difference between the AHE and HEV-ALF groups ( > 0.05). Both IFN- and IL-10 showed gradual upward trend from the HC group to the AHE (both < 0.01), but IFN- showed a sharp downward trend from the AHE group to the HEV-ALF group ( < 0.01) and IL-4 showed gradual upward trend from the AHE group to the HEV-ALF group ( < 0.01).There was no significant difference in Th1 and Th2 cytokines between the HEV RNA(+) group and HEV RNA(-) group (all > 0.05). Th2 bias was observed from the AHE (ratio = 58.65) to HEV-ALF (ratio = 1.20) groups. The level of IFN- was associated with the outcome of HEV-ALF patients.
HEV viral load was not associated with aggravation of AHE, and the HEV-ALF patients showed significant Th2 bias, which may be involved in the aggravation of AHE.
细胞免疫在戊型肝炎病毒（HEV）感染的发展中的作用很少见。我们旨在研究病毒载量和 Th 细胞反应在急性戊型肝炎（AHE）和 HEV 相关急性肝衰竭（HEV-ALF）中的作用。
我们评估了 34 例 HEV 感染患者的病毒载量和 Th1/Th2 细胞因子水平，包括 17 例 AHE 和 17 例 HEV-ALF 患者。还包括 17 例抗-HEV IgM 和 IgG 均为阴性的健康对照（HC）。
AHE 和 HEV-ALF 组的病毒载量和 HEV RNA 无显著差异（均 > 0.05）。AHE 和 HEV-ALF 组的 Th 淋巴细胞水平（CD3+，CD4+）明显高于 HC 组（均 < 0.05），但两组之间无显著差异（ > 0.05）。IFN-和 IL-10 均从 HC 组到 AHE 呈逐渐上升趋势（均 < 0.01），但从 AHE 组到 HEV-ALF 组 IFN-呈急剧下降趋势（ < 0.01），IL-4 从 AHE 组到 HEV-ALF 组呈逐渐上升趋势（ < 0.01）。HEV RNA（+）组和 HEV RNA（-）组的 Th1 和 Th2 细胞因子无显著差异（均 > 0.05）。从 AHE（比值=58.65）到 HEV-ALF（比值=1.20）组观察到 Th2 偏倚。IFN-水平与 HEV-ALF 患者的结局相关。
HEV 病毒载量与 AHE 加重无关，HEV-ALF 患者表现出明显的 Th2 偏倚，这可能与 AHE 加重有关。
