Changes Of Circulating Dendritic Cells In Chronic HBV-infected Patients And Influences Of Which By Treatment With Intergrative Traditional Chinese And Western Medicine

Objective: To investigate the features of circulating DCs in patients with different HBeAg expression and HBVDNA level of chronic hepatitis B. And to observe the influences of intergrative traditional Chinese and western medicine treatment on number and function of circulating DCs in chronic HBV-infected patients. Method: (1)The fresh blood samples were collected from 41 patients with cronic hepatitis B (CHB),including 29 patients with postive HBeAg and 12 patients with negtive HBeAg ,and 46 healthy individuals as controls. DCs were isolated from peripheral blood mononuclear cells (PBMCs) using Ficoll-Hapaque and detected by flow cytometry. Fresh PBMCs were stimulated by in vitro CpG 2216, IL-3, Poly I:C as stimulator for 24 hours,respectively and measured by ELISA for IFN-α IL-12 production.(2)In the same way,fresh PBMCs were measured by ELISA for IFN-α IL-12 production of HBeAg postive patients,different from 15 patients HBVDNA higher than 10~7copies/mL to 14 patients HBVDNA lower than 10~7copies/mL.(3)Observe the difference on number and function of circulating DCs in chronic HBV-infected patients with treatment Fufang Huangqi Keli at different course. Result: (1) The yield of IL-12 and IFN-α in CHB patients was markedly lower than the counterparts in healthy controls.The frequency of peripheral mDCs had the trend of HBeAg negtive group>healthy controls>HBeAg postive group, and the frequency of peripheral pDCs had the trend of healthy controls>HBeAg negtive group>HBeAg postive group.(2) There were no significant difference on the frequency of pDCs and difference on the yield of IFN-α, in comparision with low and high HBVDNA level among HBeAg postive CHB patients. The yield of IL-12 producted by mDCs ( pg/ml) in high HBVDNA level patients was markly lower than low HBVDNA level patients,P<0.01.(3)At 12, 24, 48 weeks, the negative-turning rate of HBVDNAin the intergrative treatment group was 87.50% ( 7/8cases X 77.78 % ( 7/9cases )> 71.43 % ( 5/7cases), the negative-turning rate of HBeAg is 75.00 % ( 6/8cases X 88.89% (8/9casesX 100% ( 7/7cases ), higher than that of the other two groups, P>0.05. (4) The count of mDCs> pDCs was increased with the time going on, P>0.05.AT the 12 weeks the IL-12 output came to the highest level and then reduced, f>0.05o While the output IFN- a reduced first at the 2 weeks, then came back to the highest level, and reduced again at last.Conclusions: There was no obvious relation between the number and function of circulating DCs and HBeAg expression in chronic HBV-infected patients.While high HBVDNA level perhaps made the DCs function defect.The curative effect in group of Fufang Huangqi Keli and lamivudine jointly treatment was markly better than the other two one way treatment group,supplemented with each other for restraining HBeAg and HBVDNA.The jointed treatment could encouraged the number increase and the function of peripheral DCs.