CAJ | 학술논문

目的观察慢性乙型肝炎(chronic hepatitis B,CHB)患者阿德福韦酯(adefovir dipivoxil,ADV)抗病毒治疗前后外周血树突状细胞(dendritic cells,DC)和淋巴细胞亚群动态变化,探讨ADV抗HBV的免疫效应机制.方法对15例ADV抗病毒治疗有效的CHB患者动态观察1年,设健康对照组10例.在治疗前、治疗3个月、6个月和1年对外周血单核细胞源DC进行体外培养,流式细胞仪检测分析DC表面分子及淋巴细胞亚群水平.结果 15例CHB患者均治疗持续有效.与治疗前比较,治疗3个月时DC表面分子CD1a、CD83、CD86和MHC-DR的表达无明显变化;治疗6个月和1年时上调,但二时相比较差异无显著性,且均低于健康对照组.淋巴细胞亚群于抗病毒3个月时亦无明显变化;治疗6个月和1年时,CD~4+T及CD4~+/CD8~+T比值显著提高;NK比例虽有上升趋势,但与治疗前比较差异无显著性;CD3~+T、CD8~+T和CD19~+B细胞未见明显改变.结论 ADV治疗后CHB患者免疫增强,提示其可能通过调节DC和淋巴细胞亚群的功能而参与免疫应答,发挥间接抗病毒作用.
목적 관찰만성을형간염(chronic hepatitis B,CHB)환자아덕복위지(adefovir dipivoxil,ADV)항병독치료전후외주혈수돌상세포(dendritic cells,DC)화림파세포아군동태변화,탐토ADV항HBV적면역효응궤제.방법 대15례ADV항병독치료유효적CHB환자동태관찰1년,설건강대조조10례.재치료전、치료3개월、6개월화1년대외주혈단핵세포원DC진행체외배양,류식세포의검측분석DC표면분자급림파세포아군수평.결과 15례CHB환자균치료지속유효.여치료전비교,치료3개월시DC표면분자CD1a、CD83、CD86화MHC-DR적표체무명현변화;치료6개월화1년시상조,단이시상비교차이무현저성,차균저우건강대조조.림파세포아군우항병독3개월시역무명현변화;치료6개월화1년시,CD~4+T급CD4~+/CD8~+T비치현저제고;NK비례수유상승추세,단여치료전비교차이무현저성;CD3~+T、CD8~+T화CD19~+B세포미견명현개변.결론 ADV치료후CHB환자면역증강,제시기가능통과조절DC화림파세포아군적공능이삼여면역응답,발휘간접항병독작용.
Objective To observe the dynamic changes of dendritic cells (DCs) and lymphocytes subsets from peripheral blood of patients with chronic hepatitis B (CHB) treated with adefovir dipivoxil(ADV) and explore the influence on the cellular immunity after ADV therapy. Methods Fifteen CHB patients treated with ADV and ten health controls were included and followed up for one year in this study. DCs were isolated from peripheral blood and cultured in vitro at baseline, 3, 6 and 12 months. Subsequently, flow cytometry (FCM) was applied to quantify the surface markers of DCs and lymphocyte subsets. Results ADV antiviral therapy was consistently effective on the 15 patients. In comparison with baseline, no signifiant change occurred at 3 months after ADV therapy. However, the expression level of CD1a, CD83, CD86 and MHC-DR of DCs, as well as CD4~+T and CD4~+/ CD8~+T cell ratio, was up-regulated at 6 months and 1 year, though still lower than those in control group. NK cell also increased, but there was no statistically significant difference compared with baseline. Furthermore no significant changes were found in CD3~+T, CD8+T and CD19~+B cell. Conclusion The immunity of CHB patients can be enhanced by ADV, suggesting that ADV possibly participate in the immune response through modulation of functions of DCs and lymphocytes subsets, thus play an indirect antivirus function.