CD4+、CD25+调节性T细胞在重型乙型肝炎发病中作用.doc

CD4+、CD25+调节性T细胞在重型乙型肝炎发病中作用 　【摘要】 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（Plt;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lt;0．01）；重型乙型肝炎组外周血HBVDNA滴度为1.2×104 copies/ml，较慢性乙型肝炎组(2.3×106 copies/ml)和无症状HBV携带者(7.8×105 copies/ml)差异有非常显著性（P均lt;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。 【关键词】 CD4+、CD25+调节性T细胞 重型乙型肝炎 CD8+T细胞反应 　　【Abstract】Objective To explore the possible role of CD4＋、CD25＋ 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, Plt;0.05) , chronic asymptomatic HBV carriers(Plt;0.01) and healthy controls (Plt;0.01) 2.There were significant differences on HBVDNA serum levels of Severe hepatitis B patients(1.2×104 copies/ml) when compared with chronic hepatitis B patients( 2.3×106copies/ml，Plt;0.01) , chronic asymptomatic HBV carriers (7.8×105copies/ml，Plt;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 virus and the low expression of CD4＋、CD25＋ Tr in PBMCs is correlated with pathogenesis of severe hepatitis B. 　　【Key words】 CD4＋、CD25＋ Regulatory T Cells severe hepatitis B CD8+ T cell response 　　HBV感染所诱导的细胞免疫反应是机体清除HBV的主要方法，但免疫反应过强，在清除HBV的同时易造成广泛的肝细胞坏死和凋亡，从而诱发出重型肝炎。然而重型乙型肝炎患者细胞免疫反应过度的原因迄今尚不清楚,故探讨其反应过度对阐明重型乙型肝炎的发病机制具有重要意义。CD4+、CD25+ 调节性T细胞(CD4+、C