聚乙二醇干扰素α-2a对慢性乙型肝炎患者树突状细胞B7-H1表达的影响

目的：观察聚乙二醇干扰素α-2a对慢性乙型肝炎患者外周血树突状细胞功能及B7-H1的影响，探讨慢性乙型肝炎病毒逃逸的的机制。方法：慢性乙型肝炎患者31例，给予聚乙二醇干扰素α-2a180txg抗病毒治疗52周，分别于0、12、26、52周检测肝功能、HBV-DNA；流式细胞术检测外周血mDC表面HLA-DR、CD80、CD86、CD83、CDla、B7一H1水平。根据患者HBV—DNA水平，将患者分为应答组（A组）、非应答组（B组），10例健康志愿者作正常对照组（C组）。结果：慢性乙肝患者的树突状细胞膜表面分子HLA-DR、CD80、CD86、CD83、CDla的表达均降低。聚乙二醇干扰素α-2a治疗后应答组膜表面分子HLA-DR、CD80、CD86、CD83、cDla的表达高于非应答组65．3±6．2％VS44．2±5．5％，67．2±7．4％VS37.3±7．2％，68．4±3．6％VS42．5±7．3％，65．6±6．8％VS43．2±3．9％，49．4±9．5％VS37．5±7．9％，（P〈0．05）。应答组B7-H1表达水平较治疗前下降，非应答组B7-H1水平无明显变化12．73±3．8％VS25．24±2．92％，（P〈0．05）。结论：慢性乙型肝炎患者树突状细胞功能低下，聚乙二醇干扰素α-2a治疗可以提高树突状细胞功能，降低B7-H1表达，促进HBV-DNA的清除。树突状细胞功能低下及B7-H1高表达是乙型肝炎病毒免疫逃逸的因素之一。

Dynamic Changes of the Expression of B7-H1 on DCs in Chronic Hepatitis B Patients Treated with PEG-IFN alpha-2a

Objective： To study the dynamic changes of the expression of B7-H1 on dendritic cells （DCs） in chronic hepatitis B （CHB） patients undergoing PEG-IFN alpha-2a therapy. Methods： 31 patients with chronic hepatitis B were given with PEG-IFN alpha-2a 180 Ixg, once a week for 52 weeks. Hepatic function and HBV-DNA were detected at week of 0, 12, 26, 52 respectively. The expression of HLA-DR, CD80, CD86, CD83, CDla, B7-H1 on DCs were detected by flow cytometry. According to HBV-DNA levels, the patients were divided into responding group （A）, non-responding group （group B）, 10 healthy volunteers as control group （group C）. Results： The expression of HLA-DR, CD80, CD86, CD83, CDla on DCs in patients with CHB were lower than control group （P〈0.05）. After PEG-IFN alpha-2a therapy, the expression of HLA-DR, CD80, CD86, CD83, CDla on DCs upregulated in responding group than non-responding group （65.3± 6.2 % vs 44.2± 5.5 %, 67.2± 7.4% vs 37.3± 7.2 %, 68.4± 3.6 % vs 42.5± 7.3 %, 65.6± 6.8 % vs 43.2± 3.9 %, 49.4± 9.5 % vs 37.5± 7.9 %, （P〈0.05））. B7-H1 expression on DCs were persistently decreased in the responding group after PEGIFN α-2a treatment, while nonresponding group maintained high level of B7-H1 expression （12.73± 3.8 % vs 25.24± 2.92 %,（P 〈0. 05））. Conclusion： PEG-IFNα-2a therapy can improve the function of dendritic cells. The expression of B7-H1 on DCs was down-regulated with HBV-DNA clearance after PEGIFN α-2a treatment. Dendritic cell dysfunction indicated by the increased B7-H1 expression is one of the factors of hepatitis B virus immune escape.