自身免疫性肝炎患者外周血单核细胞APRIL、BAFF mRNA水平与临床特点的关系

摘要/Abstract

摘要： 目的探究自身免疫性肝炎(AIH)患者外周血单核细胞增殖诱导配体(APRIL)和B淋巴细胞刺激因子(BAFF) mRNA水平与临床特点的关系。方法将2021年1月至2024年12月启东市人民医院就诊的56例AIH患者作为研究对象,所有患者均接受临床标准疗法进行治疗,持续治疗6个月后评估其生化学应答情况,将发生生化学应答者纳入应答组,否则纳入不应答组。通过荧光定量逆转录PCR技术分别检测两组治疗前外周血单核细胞中APRIL和BAFF mRNA的相对表达量,比较两组的临床资料和单核细胞APRIL与BAFF mRNA水平,选取临床资料中差异具有统计学意义的指标,分析其与单核细胞中APRIL和BAFF mRNA水平的相关性。结果治疗后,AIH患者中有37例表现为生化学应答,其生化学应答率为66.07%,归为应答组,另外19例归为不应答组。不应答组中合并肝硬化占比为57.89%(11/19),较高于应答组(27.03%,10/37);不应答组的平均血小板体积(MPV)、总胆红素水平和免疫球蛋白G水平分别为(10.5±1.8)fL、(48.7±7.4)μmol/L和(25.8±4.7)g/L,较高于应答组,分别为[(8.6±1.5)fL、(43.9±6.9)μmol/L和(21.4±4.1)g/L](均P<0.05);不应答组的血小板计数和白蛋白水平分别为(105.2±17.5)×10⁹/L与(34.6±3.8)g/L,较低于应答组,分别为[(132.3±22.9)×10⁹/L与(38.7±4.3)g/L](均P<0.05)。相比于应答组,不应答组的外周血单核细胞中的APRIL和BAFF mRNA相对表达量均较高(P<0.05)。AIH患者外周血单核细胞中,APRIL和BAFF mRNA的表达水平与MPV及免疫球蛋白水平均呈正相关(P<0.05),与血小板计数与白蛋白水平均呈负相关(P<0.05)。结论 AIH患者外周血单核细胞APRIL、BAFF mRNA水平异常升高均与其治疗后不表现出生化学应答有关,且其水平与患者病情具有一定的相关性。

关键词: 自身免疫性肝炎, 单核细胞, 增殖诱导配体, B淋巴细胞刺激因子, 临床特点

Abstract: Objective The aim of this study was to explore the relationship between a proliferation-inducing ligand (APRIL) and B-cell activating factor (BAFF) mRNA in peripheral blood mononuclear cells and clinical characteristics in patients with autoimmune hepatitis (AIH). Methods A total of 56 patients with AIH admitted from January 2021 to December 2024 in Qidong People′s Hospital were selected as the study subjects. All patients received clinical standard therapy and their biochemical response was evaluated after 6 months of continuous treatment. Those who achieved a biochemical response were included in response group, otherwise they were included in non-response group. The relative expression levels of APRIL and BAFF mRNA in peripheral blood mononuclear cells were detected by fluorescent quantitative reverse transcription PCR. The clinical data and mRNA levels of APRIL and BAFF in the two groups were compared. The correlations between clinically significant variables and APRIL and BAFF mRNA levels were analyzed. Results After treatment, Thirty-seven patients with AIH showed biochemical response, with a biochemical response rate of 66.07%, and were classified as response group, while the remaining 19 cases were classified as non-response group. The proportion of cases with concurrent cirrhosis in the non-response group was 57.89%(11/19), which was higher than that in response group (27.03%, 10/37) (P<0.05); the mean platelet volume (MPV), total bilirubin level (TBil), and immunoglobulin G (IgG) level in non-response group were (10.5±1.8) fL, (48.7±7.4) μmol/L, and (25.8±4.7) g/L, respectively, which were higher than those in response group [(8.6±1.5) fL, (43.9±6.9) μmol/L, and (21.4±4.1) g/L, respectively] (P<0.05); the platelet count (PLT) and albumin (Alb) levels in non-response group were (105.2±17.5) × 10⁹/L and (34.6±3.8) g/L, respectively, which were lower than those in response group [(132.3±22.9) × 10⁹/L and (38.7±4.3) g/L, respectively] (P<0.05). Compared with response group, the relative expression levels of APRIL and BAFF mRNA in peripheral blood mononuclear cells of non-response group were higher (P<0.05). The expression levels of APRIL and BAFF mRNA in peripheral blood mononuclear cells of AIH patients were positively correlated with MPV and IgG levels (P<0.05), and negatively correlated with PLT and ALB levels (P<0.05). Conclusion The abnormal elevation of APRIL and BAFF mRNA levels in peripheral blood mononuclear cells of AIH patients is related to their lack of biochemical response after treatment, and their levels are correlated with the patients′ condition.

Key words: Autoimmune hepatitis, Mononuclear cell, A proliferation inducing ligand, B-cell activating factor, Clinical characteristic

尹明月, 许赛华, 蒋黎黎, 张留超, 薛学锋, 周娅丽. 自身免疫性肝炎患者外周血单核细胞APRIL、BAFF mRNA水平与临床特点的关系[J]. 肝脏, 2026, 31(7): 1039-1043.

Yin Mingyue, Xu Saihua, Jiang Lili, Zhang Liuchao, Xue Xuefeng, Zhou Yali. Relationship between APRIL and BAFF mRNA in peripheral blood mononuclear cells and clinical characteristics in patients with autoimmune hepatitis[J]. Chinese Hepatolgy, 2026, 31(7): 1039-1043.

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