| BackgroundLiver failure is a kind of severe liver disease with jaundice, ascites, hepatic encephalopathy and coagulation disorders as its primary manifestation caused by a variety of factors leading to massive hepatic cell necrosis. Its progress is rapid with complex clinical symptoms. It is a serious threat to human health because of the poor prognosis and high rate of death rate which is about60～70%.Currently the close relationship between liver failure and immune response dysfunction is recognised more clearly. NK cell is an important constituent of the innate immune system which plays a very important role in the antiviral response. Their effects on target cells can be in a relatively short period of time without the prior sensitization. NK cells are labeled with CD56and CD16molecules, without the expression of CD3or T cell antigen receptor (TCR). According to the expression of CD56and CD16on the surface or not, NK cells can be divided into three major subsets which are CD56+, CD56+CD16+and CD16+. CD56is the differentiation of specific markers while the expression of CD16is closely related to the killing activity of NK cells. The sequence of the killing activity of each subset can be described as this:CD16+>CD56+CD16+>CD56+. Hepatitis B virus infection is the major cause of liver failure in China. The immune-mediated reactions in the pathogenesis and prognosis of HBV infection also plays an important role in chronic hepatitis B because of the hepatitis B virus is not a cytopathogenic virus.The NK lymphocyte and the proportion of NK cell subsets in peripheral blood were analysed on the patients of chronic hepatitis B and liver failure with chronic hepatitis B by flow cytometric in this research. Discuss the significance of developing action in chronic hepatitis B and liver failure. This topic came from Hubei Province Natural Science Fund Project (Code:2008CDA049).ObjectiveTo investigate the characteristics of the proportion of NK cells and their subsets in patients with chronic hepatitis B and liver failure, and explore its clinical significance of them.MethodsPatients of chronic hepatitis B with liver failure, chronic hepatitis B and a healthy control group were included in the subjects.30cases of patients with chronic hepatitis B of liver failure and30cases of patients with chronic hepatitis B were collected in Department of Infectious Diseases of Wuhan Tongji Hospital from September2010to May2011.25cases of normal control were collected from the medical examination center. Recorded the patients’general information (such as gender, age).Peripheral blood mononuclear cells (PBMC) were obtained by Ficoll density gradient separation of each blood specimen, and dyed with fluorescent antibodies CD3-FITC, CD16-PE, CD56-APC within6hours. NK cell subsets in peripheral blood were counted by FCM. Printed the result co-exist. And detection of liver function, blood coagulation and HBV-DNA in patients were done by laboratory personnel on the same day. Record the results, and calculated the MELD score of the patients with liver failure.SPSS13.0statistical software were used for statistical analysis. Using rank sum test since the data did not conform to the normal distribution. Statistical significance was set at P<0.05level.ResultsNormal control group of NK cells in peripheral blood was28.5%(18.45%,32.65%), in which the subset of CD56+9.71%(5.02%,13.81%), the subset of CD56+CD16+58.37%(53.42%,66.88%) and the subset of CD16+30.74%(4.89%,37.41%). NK cells in chronic hepatitis B with liver failure was22.9%(17.9%,33.58%), in which the subset of CD56+26.7%(19.13%,34.18%), the subset of CD56+CD16+60.90%(49.38%,69.76%) and the subset of CD16+11.16%(4.53%,17.61%). NK cells of chronic hepatitis B was33.65%(23.23%,50.95%), in which the subset of CD56+22.49%(9.73%,31.76%), the subset of CD56+CD16+59.75%(49.98%,74.36%), the subset of CD16+15.53%(8.85%,22.06%).The constituent ratio of CD3-CD56+subset increased in patients of chronic hepatitis B with liver failure as well as in patients with chronic hepatitis B compared to normal controls, while the constituent ratio of CD3-CD16+subset decreased (P<0.01)The proportion of NK cells decreased in patients of chronic hepatitis B with liver failure compared to patients with chronic hepatitis B(P<0.01), but there were no statistical significance in the constituent ratio of NK cell subsets(P>0.05).The average MELD score of patients of liver failure with chronic hepatitis B group was22.0+/-7.0points, and patients peripheral blood of NK cells CD16+subsets proportion were positively correlated with its rating (r=0.444, p=0.016).Conclusions1. The disorder of NK subsets constitute may be one of the mechanisms of onset of liver failure with chronic hepatitis B.2. Declining proportion of NK cells may be the drivers of chronic liver failure caused by hepatitis B. 3. There may be a positive correlation between the proportion of CD16+NK cell in the peripheral blood of the patients of liver failure with chronic hepatitis B and their MELD scores. |
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