目的 探讨白细胞介素21(Interleukin-21,IL-21)参与e抗原(hepatitis B e antigen,HBeAg)阳性慢性乙型肝炎(chronic hepatistis B,CHB)免疫病程的进展.方法 入组2022年1月-2023年1月间由常州市金坛第一人民医院、镇江市第三人民医院诊治的HBeAg阳性CHB患者45例、CHB患者免疫耐受状态(immune tolerant,IT)20例、非活动表面抗原(hepatitis Bs antigen,HBsAg)携带者(inactive carrier,IC)45例,在抗病毒治疗前及治疗48周后分别检测HBV血清标志物(HBeAg、HBsAg、Anti-HBs、Anti-HBe、Anti-HBc)、ALT、HBV DNA 载量、IL-21 浓度、IL-21+CD4+T 细胞、IL-21R+CD4+T细胞频数.同时选取15例健康体检者检测相同指标作为对照.结果 CHB和IC组患者的血清IL-21浓度[分别为(82.21±22.32)、(72.32±25.26)μg/mL]均显著高于 HBeAg 阳性免疫耐受患者[(20.24±15.56)pg/mL,P 值均＜0.001],IC 组患者的 IL-21+CD4+T 细胞频数为(7.42±2.34)％、IL-21R+CD4+T 细胞频数为(6.46±1.55)％,均显著高于CHB组(P值均＜0.001).血清ALT与IL-21浓度无相关性(r=0.136,P=0.20).HBeAg阳性CHB患者抗病毒治疗后达到HBeAg血清学转换组治疗前外周血IL-21浓度为(92.58±25.76)pg/mL、IL-21+CD4+T细胞频数为(7.89± 2.05)％、IL-21R+CD4+T细胞频数(7.01±1.51)％,均显著高于未达到HBeAg血清学转换组(P值均＜0.01).结论 IL-21参与了HBeAg阳性CHB免疫病程的进展.
Study on the IL-21 participate in the immunopathogenesis of HBeAg-positive chronic hepatitis B
Objective To investigate the involvement of Interleukin-21(IL-21)in the immune response of individuals with HBeAg positive chronic Hepatitis B(CHB).Methods 45 HBeAg-positive CHB patients,20 CHB patients in the immune tolerant(IT)phase,and 20 HBeAg-negative CHB patients in the inactive carrier(IC)phase were enrolled in this study.Levels of HBV serum markers,such as HBeAg,HBsAg,Anti-HBs、Anti-HBe、Anti-HBc,as well as ALT,HBV DNA levels,IL-21 cocentration,frequencies of IL-21+ CD4+ T cells,and frequencies of IL-21R+ CD4+ T cells were assessed before and after 48 weeks of antiviral therapy.Additionally,15 healthy volunteers were included as a control group and were assessed during the same period.Results The serum concentration of IL-21 in the CHB group(82.21±22.32 pg/mL)and IC groups(72.32±25.26 μg/mL)was significantly higher compared to IT group(20.24±15.56 μg/mL,P＜0.001).The frequency of IL-21+CD4+ T cells(7.42±2.34)％and IL-21 R+CD4+T cells(6.46±1.55)％in the IC group was higher compared to the CHB group(P＜0.001).No correlation was observed between serum ALT levels and IL-21 concentration(r=0.136,P=0.20).Furthermore,the IL-21 level(92.58±25.76 pg/mL),as well as the frequency of IL-21+ CD4+ T cells(7.89±2.05)％and IL-21 R+ CD4+ T cells(7.01±1.51)％,were significantly higher in the peripheral blood of HBeAg-positive CHB patients who achieved HBeAg serologic conversion after antiviral therapy compared to those who did not(P＜0.01).Conclusion IL-21 plays a significant role in the immunopathogenesis of HBeAg-positive chronic hepatitis B.
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万方数据
维普
