HBV变异患者外周血CD4+CD25+调节性T细胞变化及其临床意义

Objective To study the relationship Between circulating CD4+CD25+ Regulatory T (Tregs) Cells and hepatic expression of CD8+T in HBV mutation patients.Its clinical significance was also surveried.Methods A total of 80 subjects, including 64 chronic hepatitis B patients (CHB) , 16 acute hepatitis B patients (AHB) were enrolled in the study.Of CHB patients, 27 patients with HBV mutation (22 with natural Pre C mutation, 5 with YMDD mutation related Lamivudin) .The gender and average age were comparable between CHB and AHB patients.The Tregs were determined by FCM.The hepatic expression of CD8+T were measured by immunohistochemistry stain.The quantity HBV-DNA and HBV mutation were detected by PCR.Results The frequency of Tregs in AHB and HBV mutation with exacerbation of liver disease patients were decreased, compared to that in CHB without HBV mutation (3.00±1.33, 2.57±0.83 vs 4.77±2.11, P<0.01) .However, the frequency of Tregs in HBV mutation without exacerbation of liver disease patient were comparable to that in CHB without HBV mutation patients (4.32±0.96 vs 4.77±2.11, P>0.05) .The frequency of Tregs cells was positively correlated with serum HBV DNA load.The hepatic CD8+T expression were significantly incresesd in AHB and HBV mutation with exacerbation of liver disease patients.The negtive relationship between hepatic CD8+T and circulating Treg was also observed.Conclusion The positive relationship between the decreased Tregs and exacerbation of liver disease in patients with HBV mutation is certified.The increased hepatic expression of Cd8+T may be contributed to exacerbation of liver disease.This may play an important role in HBV mutation result in immune hepatic injury.