IL-21参与HBeAg阳性慢性乙型肝炎的免疫发病机制的研究

摘要/Abstract

摘要： 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 B s 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)pg/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。

关键词: 慢性乙型肝炎, 白细胞介素-21, 免疫

Abstract: 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 pg/mL) was significantly higher compared to IT group (20.24±15.56 pg/mL, P<0.001). The frequency of IL-21⁺CD4⁺T cells (7.42±2.34)% and IL-21R⁺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-21R⁺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.

Key words: Chronic hepatitis B, IL-21, Immunity

蔡云, 赵凯, 潘良, 周鑫. IL-21参与HBeAg阳性慢性乙型肝炎的免疫发病机制的研究[J]. 肝脏, 2024, 29(4): 436-439.

CAI Yun, ZHAO Kai, PAN Liang, ZHOU Xin. Study on the IL-21 participate in the immunopathogenesis of HBeAg-positive chronic hepatitis B[J]. Chinese Hepatolgy, 2024, 29(4): 436-439.

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