难治性慢性丙型肝炎患者抗病毒治疗中NK细胞和Treg细胞的动态变化

Linchuang Gandanbing Zazhi

CHEN Xiaoyun¹ 

[1] International Medicine Ward, Beijing YouAn Hospital, Capital Medical University;

关键词: hepatitis C;    chronic;    antiviral agents;    killer cells;    natural;    T-lymphocytes;    regulatory;   

DOI  :  10.3969/j.issn.1001-5256.2014.06.008

来源: DOAJ

【 摘 要 】

ObjectiveTo investigate the changes in NK cells and regulatory T (Treg) cells among patients with refractory chronic hepatitis C (CHC) during antiviral therapy and to analyze antiviral effect-related immunological factors. MethodsA total of 41 patients with refractory CHC (30 treatment-naive patients and 11 treatment-unresponsive patients) and 11 healthy controls (HC) were enrolled in this prospective open cohort study. Naive patients received pegylated interferon α-2a (Peg-IFN-α-2a) 180 μg/week and ribavirin (RBV) 10.6-15 mg/kg/day for 48 weeks, while unresponsive patients received Peg-IFN-α-2a 180 μg/week and RBV 15 mg/kg/day for 72 weeks. Blood cells and serum were dynamically collected to measure HCV RNA, liver function, NK cells and Treg cells and to analyze curative effect-related immunological factors. Continuous variables were analyzed by t-test or rank sum test, and discrete variables were analyzed by chi-square test. ResultsAll patients finished antiviral treatment and 24-week follow-up survey. Seventeen naive patients (56.7%) and 3 unresponsive patients (27.2%) achieved a sustained virologic response (SVR). The other 13 naive patients and 8 unresponsive patients without SVR were named response-free patients. At baseline, the percentage of NK cells in patients was lower than that in the HC group, while the percentage of Treg cells in patients was higher than that in the HC group. During antiviral therapy, in naive patients with SVR, the percentage of NK cells increased at week 24 of treatment, as compared with the baseline and week 4, and the percentage of Treg cells decreased at week 24, as compared with the baseline and week 4; In naive patients without SVR, the percentage of Treg cells increased at week 24, as compared with the baseline and week 4; no significant change in the percentage of NK cells or Treg cells was observed in unresponsive patients without SVR.ConclusionDecrease in NK cells and increase in Treg cells are related to chronic HCV infection. Dynamic changes in NK cells and Treg cells can predict the efficacy of antiviral therapy: the increase in NK cells and decrease in Treg cells, which are indicative of upregulation immune function and downregulation of immunosuppression, can be used for predicting SVR.

【 授权许可】

Unknown