CAJ | 학술논문

目的：探索慢性乙型肝炎患者外周血IL-35及Th17/Treg表达对临床转归的免疫作用。方法30例慢加急性肝衰竭患者（ACLF）、26例接受聚乙二醇α-2a干扰素（Pegylated interferon-α-2a, PEG-IFN-α-2a）治疗48周完全应答慢乙肝患者均来自于苏州大学附属第一医院感染科，健康对照者（HA）15名来自于健康体检者，分别ELISA、流式细胞学检测各组血清中IL-35浓度及Th17、CD4+CD25+FOXP3 Treg占CD4+T细胞比例。结果 ACLF组、CHB组及CR组IL-35浓度均高于HA组（P＜0.05），Th17细胞由高到低分别为ACLF组、CHB组、CR组，且较HA组均有统计学意义（P＜0.05），而Treg细胞有相反的变化（P＜0.05），ACLF组IL-35浓度与Treg正相关，与Th17负相关。结论 ACLF患者免疫功能严重失衡，IL-35、Th17、Treg细胞在此过程中起着重要的作用，干扰素可以使早期炎性活动的慢乙肝患者免疫功能一定程度恢复，但并不能完全恢复正常。
목적：탐색만성을형간염환자외주혈IL-35급Th17/Treg표체대림상전귀적면역작용。방법30례만가급성간쇠갈환자（ACLF）、26례접수취을이순α-2a간우소（Pegylated interferon-α-2a, PEG-IFN-α-2a）치료48주완전응답만을간환자균래자우소주대학부속제일의원감염과，건강대조자（HA）15명래자우건강체검자，분별ELISA、류식세포학검측각조혈청중IL-35농도급Th17、CD4+CD25+FOXP3 Treg점CD4+T세포비례。결과 ACLF조、CHB조급CR조IL-35농도균고우HA조（P＜0.05），Th17세포유고도저분별위ACLF조、CHB조、CR조，차교HA조균유통계학의의（P＜0.05），이Treg세포유상반적변화（P＜0.05），ACLF조IL-35농도여Treg정상관，여Th17부상관。결론 ACLF환자면역공능엄중실형，IL-35、Th17、Treg세포재차과정중기착중요적작용，간우소가이사조기염성활동적만을간환자면역공능일정정도회복，단병불능완전회복정상。
Objective To explore the immune function of IL-35 and Th17/Tregs in the peripheral blood of chronic HBV patients.Methods30 ACLF patients and 26 CHB patients who accept 48 weeks PEG-IFN-α-2a treatment are grouped from the First Affi liated Hospital of Soochow University. The HA cases included 15 healthy volunteers. The serums of IL-35 were measured with ELISA. Th17 and CD4+CD25+FOXP3 Treg cells in PBMC were determined by Flow cytometry.ResultsThe levels of IL-35 of ACLF, CHB and CR groups are signifi cantly higher than HA cases (P<0.05). The sequence of Th17 cells, from high to low, was ACLF group, CHB group, CR group and HA group (P<0.05), and Treg cells were just the opposite (P<0.05). The level of IL-35 on ACLF patients was negative correlated with Th17 cells in PBMC and positive with Treg cells (P<0.05).Conclusion The immune function of ACLF patients was severe dysfunction, IL-35, and Th17/Treg cells play important roles in this process. Interferon can make early recovery, but not completely normalized.