慢性乙型肝炎患者转氨酶与外周血中髓源性抑制细胞的关系研究

doi:10.3877/cma.j.issn.2095-5820.2022.03.004

目的

探讨慢性乙型肝炎（CHB）患者外周血中髓源性抑制细胞（MDSCs）的频率及MDSCs与肝功能、慢性乙型肝炎病毒（HBV）感染之间的相关性。

方法

选择2019年3月至2019年10月于广州市第一人民医院住院或门诊就诊且未接受抗病毒治疗的30例CHB患者作为CHB患者组，同时选取同一时间段的14名健康体检者作为健康对照组。分别采用流式细胞仪（FCM）检测CHB患者组和健康对照组患者的外周血单个核细胞（PBMCs）中MDSCs的频率，对两组MDSCs频率的差异进行了组间t检验比较分析。分别用干化学法和全自动生化分析仪测定两组血清谷丙转氨酶（ALT）和谷草转氨酶（AST）；采用聚合酶链式反应（PCR）对两组HBV-DNA载量进行检测。Spearman相关分析MDSCs与HBV-DNA载量、ALT和AST的相关性。

结果

CHB患者组的MDSCs频率（2.347%）高于健康对照组（0.929%），差异有统计学意义（P=0.002）。CHB患者HBeAg阳性组和阴性组的MDSCs频率比较，差异无统计学意义（P=0.170）。CHB患者MDSCs频率与ALT、AST呈负相关（r=-0.319、r=-0.214，均P＜0.05），但MDSCs频率与HBV-DNA载量无相关性（r=-0.154，P=0.742）。

结论

CHB患者组MDSCs频率高于健康对照组，且与ALT、AST呈负相关，提示MDSCs在CHB患者外周血中募集增多，可能与CHB感染的慢性炎症相关。

关键词: 髓源性抑制细胞, 慢性乙型肝炎, 免疫耐受

Objective

To investigate the frequency of myeloid-derived suppressor cells (MDSCs) in peripheral blood of patients with chronic hepatitis B (CHB) and the correlation between MDSCs, liver function and chronic hepatitis B virus(HBV) infection.

Methods

30 CHB patients who were hospitalized or outpatient in Guangzhou First People's Hospital from March 2019 to October 2019 and did not receive antiviral therapy were selected as the CHB patient group, and 14 healthy person who underwent physical examination during the same period selected as the healthy control group. Flow cytometer (FCM) was used to detect the frequency of MDSCs in peripheral blood mononuclear cells (PBMCs) of CHB patients and healthy controls. At the same time, the HBV-DNA load of the two groups was detected by polymerase chain reaction (PCR). Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were measured by dry chemical method and automatic biochemical analyzer. Group t-test was used to compare and analyze the frequency of MDSCs between the two groups. Spearman correlation was used to analyze the correlation between MDSCs and HBV-DNA load, ALT and AST.

Results

The frequency of MDSCs in CHB group was 2.347%, substantially higher than that in control group (0.929%), and the difference was statistically significant (P=0.002). There was no significant difference in the frequency of MDSCs between HBeAg positive and negative groups in CHB patients (P=0.170). The frequency of MDSCs was negatively correlated with ALT and AST in CHB patients (r=-0.319 or -0.214, all P＜0.05), but there was no correlation between the frequency of MDSCs and HBV-DNA load (r=-0.649, P=0.115).

Conclusions

The frequency of MDSCs in CHB patients was significantly higher than that in healthy controls, and negatively correlated with ALT and AST, suggesting that the increased recruitment of MDSCs in peripheral blood of CHB patientsmay be related to the chronic inflammation of CHB infection.

Key words: Myeloid-derived suppressor cells, Chronic hepatitis B, Immune tolerance

图1 CHB患者组与健康对照组外周血MDSCs频率比较

图2 CHB患者HBeAg与MDSCs频率的关系

图3 CHB患者外周血中MDSCs频率与ALT、AST水平相关性注：3A：ALT；3B：AST

图4 CHB患者MDSCs频率与HBV-DNA的相关性

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Relationship between aminotransferase and myeloid-derived suppressor cells in peripheral blood of patients with chronic hepatitis B

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Relationship between aminotransferase and myeloid-derived suppressor cells in peripheral blood of patients with chronic hepatitis B