CAJ | 학술논문

目的：探讨HBV感染不同阶段病毒特异性T细胞反应特征。方法对北京佑安医院84例HBV感染者进行研究，分为急性乙型肝炎组（8例）、慢性乙型肝炎组（39例）、肝硬化组（17例）和HBV相关肝癌组（20例）。采用ELISPOT方法与磁珠细胞分选方法检测外周血中HBV特异性T细胞。结果（1）急性乙型肝炎组、慢性乙型肝炎组、肝硬化组及肝癌组HBV特异性T 细胞反应强度分别为（2067．00±1029．00） SFU／106 PBMCs、（288．50±57．69） SFU／106 PBMCs、（96．25±31．06） SFU／106 PBMCs、（71．47±14．26） SFU／106 PBMCs，急性乙型肝炎组病毒特异性T细胞反应最强，组间比较差异有统计学意义（P＜0．01）。（2）急性乙型肝炎组中，HBV Core（C）蛋白诱导的T 细胞释放IFN-γ反应强度为（323．90±130．30） SFU／106 PBMCs，明显高于S蛋白、P蛋白及X蛋白诱导的T细胞反应强度，组间比较差异有统计学意义（P＝0．0037）；在慢性乙型肝炎组HBV P蛋白诱导的T细胞反应最强，为（127．20±54．42） SFU／106 PBMCs，其次为S蛋白、C蛋白、X蛋白，差异有统计学意义（P＝0．0159）。（3）在肝硬化组和肝癌组，HBV X蛋白、P蛋白、S蛋白及C蛋白诱导的T细胞释放IFN-γ反应强度无明显差别，并且均低于慢性乙型肝炎患者组。结论 HBV感染者随着病情由急性乙型肝炎向慢性乙型肝炎、肝硬化、肝癌进展，病毒特异性T 细胞反应逐渐减低，不同的感染阶段病毒蛋白诱导的T细胞反应可能发挥不同的作用。
목적：탐토HBV감염불동계단병독특이성T세포반응특정。방법대북경우안의원84례HBV감염자진행연구，분위급성을형간염조（8례）、만성을형간염조（39례）、간경화조（17례）화HBV상관간암조（20례）。채용ELISPOT방법여자주세포분선방법검측외주혈중HBV특이성T세포。결과（1）급성을형간염조、만성을형간염조、간경화조급간암조HBV특이성T 세포반응강도분별위（2067．00±1029．00） SFU／106 PBMCs、（288．50±57．69） SFU／106 PBMCs、（96．25±31．06） SFU／106 PBMCs、（71．47±14．26） SFU／106 PBMCs，급성을형간염조병독특이성T세포반응최강，조간비교차이유통계학의의（P＜0．01）。（2）급성을형간염조중，HBV Core（C）단백유도적T 세포석방IFN-γ반응강도위（323．90±130．30） SFU／106 PBMCs，명현고우S단백、P단백급X단백유도적T세포반응강도，조간비교차이유통계학의의（P＝0．0037）；재만성을형간염조HBV P단백유도적T세포반응최강，위（127．20±54．42） SFU／106 PBMCs，기차위S단백、C단백、X단백，차이유통계학의의（P＝0．0159）。（3）재간경화조화간암조，HBV X단백、P단백、S단백급C단백유도적T세포석방IFN-γ반응강도무명현차별，병차균저우만성을형간염환자조。결론 HBV감염자수착병정유급성을형간염향만성을형간염、간경화、간암진전，병독특이성T 세포반응축점감저，불동적감염계단병독단백유도적T세포반응가능발휘불동적작용。
Objective To analyze hepatitis B virus ( HBV)-specific T lymphocyte responses dur-ing different stages of HBV infection.Methods Eighty-four patients with HBV infection were recruited in this study.They were divided into four groups including acute HBV infection group (8 cases), chronic HBV infection group (39 cases), hepatocirrhosis group (17 cases) and hepatocellular carcinoma group (20 ca-ses) .HBV-specific T cell responses were detected by using ELISPOT assay in combination with magnetic beads sorting assay.Results (1)The magnitudes of HBV-specific T cell responses in patients with acute HBV infection ,chronic HBV infection , hepatocirrhosis and hepatocellular carcinoma were respectively (2067.00±1029.00) SFU/106 PBMCs, (288.50±57.69) SFU/106 PBMCs, (96.25±31.06) SFU/106 PBMCs and (71.47±14.26) SFU/106 PBMCs.The differences with the magnitudes of HBV-specific T cell responses among patients from the four groups were significant (P<0.01).(2)HBV Core (HBV C) protein induced the strongest T cell responses[ (323.90±130.30) SFU/106 PBMCs] in patients with acute HBV infection in comparison with HBV-surface ( HBV S ) protein, HBV P protein and HBV X protein ( P=0.0037).The strongest T cell responses in patients with chronic HBV infection were induced by using HBV P protein [(127.20±54.42) SFU/106 PBMCs], followed by using HBV S protein, HBV C protein and HBV X protein (P=0.0159).(3)The magnitudes of IFN-γreleasing induced by HBV X protein, HBV P protein, HBV S protein and HBV C protein showed no significant differences in patients with either hepato-cirrhosis or hepatocellular carcinoma, but were lower than those induced in patients with chronic HBV infec-tion.Conclusion HBV-specific T cell responses were gradually reduced along the progression of HBV in-fection from acute HBV infection to chronic HBV infection, liver cirrhosis and hepatocellular carcinoma.The HBV-specific T cell responses induced by viral proteins might play different roles in different stages of HBV infection.