Abstract: Objective To investigate the immune imbalance of CD4⁺ T cells in patients with mild to moderate chronic hepatitis B (CHB) through exploring the relationship of the T helper cell 17 (Th17) and the related cytokines with T helper cell 1 (Th1), T helper cell 2 (Th2) and regulatory T Cell (Treg).Methods Seventy mild to moderate CHB patients and 30 healthy volunteers were enrolled, respectively. Immune cells (Th17, Th1, Th2, Treg, Th1/Th2, Treg/Th17) and main effector molecules (perforin and granzyme B) in peripheral blood were measured using flow cytometry. The related cytokines including interleukin (IL)-17, IL-6, transforming growth factor (TGF) β, interferon (IFN) γ and IL-4 were detected using enzyme linked immunosorbent assay (ELISA). Nuclear transcription factor including lonely nuclear receptor (RORγt), Foxp3 were measured using polymerase chain reaction (PCR).Results Compared with those in healthy volunteers, percentage of CD8⁺ T cells was higher but CD4⁺/CD8⁺ was markedly decreased in CHB patients (P<0.01). Levels of Th1, Th1/Th2 and Th17 were significantly increased in CHB patients, while levels of Th2, Treg and Treg/Th17 were decreased compared with control group (P<0.01). Perforin and granzyme B expression were higher in CHB patients (P<0.01). No significant difference was observed in the expression of Foxp3, IL17mRNA and RORγt between healthy volunteers and CHB patients (P>0.05). Compared with healthy volunteers, expressions of TGF-B1, IL-6 and IL-17 were increased significantly in CHB patients (P<0.01), while there was no significant difference in the expression of IFN-γ and IL-4 (P>0.05).Conclusion In mild to moderate CHB patients, the chain of immunity, including immune cells, related cytokines and effector molecules, was in a serious imbalance immune state, especially the ratio of Treg/Th17.

Key words: Chronic hepatitis B, Immune imbalance, Immune regulation, Treg /Th17