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目的观察经典HLA-Ⅱ分子(HLA-DR/DQ/DP)在慢性乙型肝炎(CHB)患者外周血树突状细胞表面的表达组合模式并探讨其临床意义。方法分离来自健康对照(HC)、慢性乙型肝炎轻中度(MCHB)、慢性乙型肝炎重度(SCHB)以及慢加急性肝衰竭(ACLF)患者的外周血单个核细胞(PBMC),采用流式细胞技术观察髓样树突状细胞(myeloid DC,mDCs)、浆样树突状细胞(plasmacytoid DC,pDCs)及表面HLA-DR/DQ/DP单阳、双阳及三阳性细胞比例,分析其与疾病严重程度之间的相关性。结果 mDC和pDC比例在HC组和MCHB组无明显差别(mDC:0.185%±0.191%vs 0.162%±0.175%,P=0.599;pDC:0.218%±0.246%vs 0.158%±0.154%,P=0.247),但SCHB组(mDC:0.079%±0.049%vs 0.185%±0.191%,P=0.023;pDC:0.095%±0.103%vs 0.218%±0.246%,P=0.027)及ACLF组(mDC:0.076%±0.052%vs 0.185%±0.191%,P=0.022;pDC:0.109%±0.082%vs 0.218%±0.246%,P=0.049)均明显低于HC组。健康对照和CHB患者mDC表面均呈现HLA-DR/DQ共同高表达、HLA-DP低表达的模式;pDC表面HLA-Ⅱ分子在HC组呈现HLA-DR/DQ共同高表达同时HLA-DP低表达模式及HLA-DR/DQ/DP共同低表达的模式,除此之外CHB患者还存在HLA-DR/DQ/DP共同低表达及HLA-DP高表达同时HLA-DR/DQ共同低表达的模式。结论与HC组相比,SCHB组及ACLF组患者的mDC与pDC的比例均明显下降。CHB患者mDC表面的HLA-Ⅱ分子表达模式与健康对照一致,而pDC表面的HLA-Ⅱ分子则呈现出多样化表达模式。差异的HLA-Ⅱ分子表达模式可能对HBV持续感染产生重要作用。
Objective To observe the expression pattern of classical HLA-Ⅱ (HLA-DR / DQ / DP) on the surface of peripheral blood dendritic cells in patients with chronic hepatitis B (CHB) and to explore its clinical significance. Methods Peripheral blood mononuclear cells (PBMCs) were isolated from patients with healthy controls (HC), chronic mild hepatitis B (MCHB), severe chronic hepatitis B (SCHB) and patients with acute and severe acute liver failure (ACLF) The expression of myeloid DC (mDCs), plasmacytoid DCs (pDCs) and HLA-DR / DQ / DP single positive, double positive and triple positive cells And the severity of the disease. Results There was no significant difference in the proportion of mDC and pDC between HC and MCHB groups (mDC: 0.185% ± 0.191% vs 0.162% ± 0.175%, P = 0.599; pDC: 0.218% ± 0.246% vs 0.158% ± 0.154%, P = 0.247 ) But not in the SCHB group (mDC: 0.079% ± 0.049% vs 0.185% ± 0.191%, P = 0.023; pDC: 0.095% ± 0.103% vs 0.218% ± 0.246%, P = 0.027) ± 0.052% vs 0.185% ± 0.191%, P = 0.022; pDC: 0.109% ± 0.082% vs 0.218% ± 0.246%, P = 0.049) were significantly lower than those in HC group. The HLA-DR / DQ overexpression and HLA-DP overexpression were found in both healthy controls and mDC surfaces of CHB patients. HLA-¢ òmolecules on the surface of pDC showed HLA-DR / DQ overexpression and HLA-DP overexpression Mode and HLA-DR / DQ / DP co-expression pattern. In addition, there was a pattern of common HLA-DR / DQ / DP co-expression and HLA-DR / DQ co-expression in CHB patients . Conclusion Compared with HC group, the ratio of mDC and pDC in SCHB group and ACLF group were significantly decreased. The HLA-Ⅱmolecule expression pattern of mDC on CHB patients was consistent with that of healthy controls, while the HLA-Ⅱmolecules on pDC surface showed a variety of expression patterns. The different patterns of HLA-Ⅱ expression may play an important role in the persistent HBV infection.