CD4^＋、CD25^＋调节性T细胞在重型乙型肝炎发病中的作用

目的探讨CD4＋、CD25＋调节性T细胞（CD4＋、CD25＋ Tr）在重型乙型肝炎病人发病机制中的作用。方法采用流式细胞术检测重型乙型肝炎病人及对照组外周血CD4＋、CD25＋ Tr的水平及应用PCR测定重型乙型肝炎病人及对照组外周血中HBVDNA滴度。结果重型乙型肝炎组外周血CD4＋、CD25＋ Tr的百分率为（2.63±0.83）%,较慢性乙型肝炎组的（4.15±1.17）%差异有显著性（P〈0.05）,较无症状HBV携带者组及健康对照组差异有非常显著性（P均〈0.01）;重型乙型肝炎组外周血HBVDNA滴度为1.2×10^4copies/ml,较慢性乙型肝炎组（2.3×10^6copies/ml）和无症状HBV携带者（7.8×105copies/ml）差异有非常显著性（P均〈0.01）;不同乙型肝炎病人外周血CD4^＋、CD25^＋ Tr的百分率与HBVDNA滴度正相关。结论CD4^＋、CD25＋^ Tr能抑制T细胞对HBV的免疫反应;重型乙型肝炎患者发病与CD4^＋、CD25^＋ Tr表达过低有关。

Possible role of CD4+ CD25+ regulatory T cells in the pathogenesis of severe hepatitis B

Objective To explore the possible role of CD4^＋ , CD^＋regulatory T cells in the pathogenesis of severe hepatitis B. Methods The frequency of CD4 ^＋ , CD25^＋ Tr in the peripheral blood mononuclear cells （PBMCs） from hepatitis B patients and healthy controls were detected by flow cytometry and their HBVDNA serum levels were detected by PCR. Results 1. A lower proportion of CD4 ^＋ , CD25^＋ Tr in PBMCs was found in severe hepatitis B patients（mean% ,2.63 ＋ 0.83）when compared with chronic hepatitis B patients（mean% ,4.15 ± 1.17, P 〈 0.05） , chronic asymptomatic HBV carriers（P 〈 0.01） and healthy controls （P 〈0.01） 2.There were significant differences on HBVDNA serum levels of Severe hepatitis B patients（1.2× 10^4 copies/ml） when compared with chronic hepatitis B patients（ 2.3 ×10^6copies/ml, P 〈 0.01 ） , chronic asymptomatic HBV carriers （7.8 × 10^5copies/ nil, P 〈 0.01 ） 3. Correlation analysis showed that there was positive correlation between HBVDNA serum levels and the frequency of CD4^ ＋ , CD25^ ＋ Tr in PBMCs in hepatitis B patients. Conclusions CD4 ^＋ , CD25^ ＋ Tr could suppress T cell response against hepatitis B vires and the low expression of CD4^＋ , CD25^＋ Tr in PBMCs is correlated with pathogenesis of severe hepatitis B.