抗HBVDC治疗慢性HBV携带者初步临床研究.docVIP

抗HBVDC治疗慢性HBV携带者初步临床研究 　　[摘要] 目的：观察HBsAg致敏患者自体外周血单个核细胞(PBMC)来源的树突状细胞(DC)疫苗（简称抗HBV-DC）治疗慢性HBV携带者的临床效果。方法：15例HBeAg阳性和5例HBeAg阴性的慢性HBV携带者接受临床试验。取外周静脉血25 ml，用密度梯度离心及贴壁法获得单核细胞，以粒细胞-巨噬细胞集落刺激因子（GM-CSF）和白细胞介素4（IL-4）诱导扩增出DC，并予HBsAg致敏DC。第7天收获DC静脉回输， 1次/周，共4次。治疗前后检测HBV标志物定量、HBV-DNA定量及肝功能。结果：治愈1例，好转18例，无效1例，总有效率为95％（19/20），治愈率5％（1/20）。结论：抗HBV-DC静脉回输可有效地抑制慢性HBV携带者的病毒复制，降低并清除病毒抗原，促进HBeAg/HBeAb的血清学转换，是一种安全、有效的治疗慢性HBV携带的方法。 　　[关键词] 树突状细胞；乙型肝炎病毒；疫苗；携带者 　　[中图分类号] R456 [文献标识码]A [文章编号]1673-7210（2008）02（c）-055-03 　　 　　Clinical research on the treatment effect of anti-HBV dendritic cell on chronic HBV carrier patients 　　WU Bang-fu1, YANG Jiang-ying1, ZHOU Yun2，ZHANG Da-wei2, WEN Ling1, XIAO Jian-kai1, WANG Qiao-yu1, WU Wei-hong1, ZHANG Mei-hua1, PAN Jie1，PENG Ying-yu2, YANG Jun2, WU Ying2 　　（1.Guangzhou Medical College Affiliated Twelfth People’s Hospital of Guangzhou City, Guangzhou510620,China;2.Pubang Biological Immunologic Technology Research Center of Guangzhou, Guangzhou510663, China） 　　[Abstract] Objective:To investigate the treatment effect of autologous HBsAg-loaded dendritic cells vaccine (anti-HBV DCs) on chronic HBV carrier patients.Methods:Monocytes were isolated from peripheral blood of 20 chronic HBV carrier patients by Ficoll-Hypaque density gradient centrifugating and cultured with plastic-adherence method. DCs were induced and proliferated from the monocytes with granulocyte-macrophage clony stimulating factor(GM-CSF) and interleukin-4 (IL-4) for 7 days. After being incubated with HBsAg, DCs were injected to patients’vein for 4 times at one week’s interval. HBV markers, HBV-DNA levels, and liver function tests in the serum of patients were tested before and after treatment. Results:The effective rate was 95％(19/20), and the cure rate was 5％(1/20). The HBsAg levels were (226.05±97.85) ng/ml and (86.47±79.33) ng/ml (t＝6.28，P＜0.001), the HBeAg levels were (3.08±1.76) Ncu/ml and (1.72±1.40) Ncu/ml (t＝3.37，P=0.005), the HBeAb levels were(0.19±0.44) Ncu/ml and (0.71±1