乙型肝炎患者肝组织中乙型肝炎病毒抗原与CD8+CD28+T细胞表达的关系及其临床意义

    The relationship between the expressions of HBV and CD8+CD28+T lymphocyte in liver tissue of hepatitis B patients and its corresponding clinical significance

    • 摘要: 目的:探讨乙型肝炎患者肝组织中乙型肝炎病毒(HBV)抗原与CD8+CD28+T细胞表达的关系及其临床意义。方法:应用免疫组织化学法和核酸原位杂交法检测轻、中、重度乙型肝炎肝组织中HBV抗原及核酸的表达,同时应用免疫组织化学法检测肝组织CD28T细胞表达并比较。结果:重度、中度、轻度乙型肝炎中HBsAg(+) HBcAg(+)、HBsAg(+) HBcAg(-)、HBsAg(-) HBcAg(+)和HBsAg(-) HBcAg(-)差异无统计学意义(P>0.05)。轻度乙型肝炎患者肝组织内CD8+CD28+T细胞水平较对照组低,中度和重度乙型肝炎患者CD8+CD28+T细胞和CD8+CD28-T细胞明显高于对照组(P<0.05),且CD8+CD28+T细胞随着炎症分级逐级升高,CD8+CD28-T细胞却随着炎症分级逐级减低(P<0.01)。HBsAg(+) HBcAg(+)中、重度慢性乙型肝炎患者,肝组织中CD8+CD28+T淋巴细胞表达低于HBsAg(+) HBcAg(-)、HBsAg(-) HBcAg(+)和HBsAg(-) HBcAg(-)慢性乙型肝炎患者的表达(P<0.05~P<0.01)。HBV DNA、HBeAg在不同分级炎症活度中表达差异均无统计学意义(P>0.05)。结论:肝组织HBV更能准确反映肝组织HBV DNA复制情况,是机体免疫状态的间接反映,可作为抗病毒治疗适应证选择及疗效预测因子。CD8+T淋巴细胞表面CD28分子的表达强度与HBV的清除密切相关,CD28高表达可促进肝细胞内HBV清除。

       

      Abstract: Objective:To study the relationship between the expressions of hepatitis B virus (HBV) antigen and CD8+CD28+T lymphocyte in liver tissue of hepatitis B patients and analyze the corresponding clinical significance. Methods:The expressions of HBV antigens and nucleic acid were detected by immunohistochemistry and situ hybridization method in each groups(mild,moderate and severe hepatitis B groups). The expression of CD28 T lymphocyte in liver tissue was determined by immunohistochemistry and the results of each group were compared. Results:There was no significant difference in the expressions of HBsAg(+) HBcAg(+), HBsAg(+) HBcAg(-),HBsAg(-) HBcAg(+) and HBsAg(-) HBcAg(-) in the three groups(P>0.05). The expression of CD8+CD28+T lymphocyte in mild hepatitis group was lower than in control group,the expressions of CD8+CD28+T lymphocyte and CD8+CD28-T lymphocyte were higher in moderate and severe hepatitis B groups than in control group(P<0.05). The expression of CD8+CD28+T lymphocyte was increased progressively,while the expression of CD8+CD28-T lymphocyte was decreased progressively with the grade of inflammation(P<0.01). The expression of CD8+CD28+T lymphocyte in moderate and severe hepatitis patients with HBsAg(+) HBcAg(+) was lower than in other groups with HBsAg(+) HBcAg(-),HBsAg(-) HBcAg(+) and HBsAg(-) HBcAg(-) (P<0.05~P<0.01). There were no significant difference about the expressions of HBV DNA and HBeAg in different levels of inflammation(P>0.05). Conclusions:HBV can reflect the replication of HBV DNA in liver tissue more accurately. As an indirect reflection of immune status, it can be used as a selector of anti-viral treatment indication and a predictor of efficacy. The expression of CD28 on the surface of CD8+T lymphocyte is closely related with the clearance of HBV,and the high expression of CD28 can promote HBV clearance in liver cells.

       

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